A primigravida at 41 weeks has a Bishop score of 3 and unfavourable cervix. Which agent achieves the most effective cervical ripening with lowest risk of uterine hyperstimulation compared to prostaglandin E2 gel?
- A Misoprostol 25 mcg vaginally every 4 hours
- B Dinoprostone (PGE2) 0.5 mg intracervically every 6 hours
- C Mechanical cervical ripening with Foley catheter balloon ✓
- D IV oxytocin starting at 2 mU/min
Correct answer: C. Mechanical cervical ripening with Foley catheter balloon
Explanation
Mechanical cervical ripening with a Foley catheter balloon is equally effective to prostaglandins for cervical ripening and has a significantly lower rate of uterine tachysystole/hyperstimulation. It is preferred in women with previous caesarean section, where prostaglandins are contraindicated due to scar dehiscence risk. Meta-analyses confirm non-inferiority of Foley balloon versus PGE2 for induction success rates with fewer CTG abnormalities.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.