A multiparous patient at 41+3 weeks has cervical assessment: dilatation 1 cm, effacement 20%, station –3, consistency firm, position posterior. A Bishop score is calculated. Which score does this cervix yield, and which ripening method is MOST appropriate?
- A Bishop score 3; dinoprostone pessary for ripening
- B Bishop score 5; direct oxytocin augmentation is appropriate
- C Bishop score 2; vaginal prostaglandin E2 (dinoprostone) for cervical ripening ✓
- D Bishop score 2; balloon catheter (Foley) mechanical ripening is preferred
Correct answer: C. Bishop score 2; vaginal prostaglandin E2 (dinoprostone) for cervical ripening
Explanation
The Bishop score is computed as: Dilatation 1 cm = 1 point; effacement 20% = 1 point; station –3 = 0 points; consistency firm = 0 points; position posterior = 0 points → total = 2. A Bishop score ≤6 indicates an unfavourable cervix requiring ripening before induction. Vaginal dinoprostone (PGE2 gel or pessary) is the most widely used pharmacological method. Mechanical methods (balloon catheter) are also appropriate, especially if prostaglandins are contraindicated (e.g., prior uterine scar). Oxytocin alone is indicated only when the cervix is already favourable (Bishop ≥6–8).
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.