A 38-year-old primigravida at 41 weeks with a cephalic presentation and adequate pelvis has a Bishop score of 3. She is to be induced. Which cervical ripening agent causes fewer uterine hyperstimulation episodes when compared with misoprostol?
- A Mechanical cervical ripening with Foley catheter ✓
- B Misoprostol 50 µg intravaginal
- C Dinoprostone PGE2 gel (Prepidil)
- D Oxytocin infusion
Correct answer: A. Mechanical cervical ripening with Foley catheter
Explanation
Mechanical cervical ripening with a transcervical Foley catheter is associated with fewer uterine hyperstimulation episodes compared with prostaglandins (both misoprostol and dinoprostone), while achieving comparable cervical ripening efficacy. It is preferred when the risk of uterine tachysystole is a concern (e.g., prior uterine surgery, fetal compromise). Dinoprostone has a more favourable hyperstimulation profile than misoprostol but still higher than mechanical methods.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.