A primigravida at 40 weeks gestation has a Bishop score of 3. Induction of labour is planned. The PREFERRED agent for cervical ripening in this case is:
- A Intracervical Foley balloon catheter
- B Dinoprostone (PGE2) vaginal pessary 10 mg ✓
- C Intravenous oxytocin infusion
- D Oral misoprostol 50 µg every 4 hours
Correct answer: B. Dinoprostone (PGE2) vaginal pessary 10 mg
Explanation
A Bishop score of 3 indicates an unfavorable cervix requiring ripening before oxytocin augmentation. Dinoprostone (PGE2) vaginal pessary 10 mg (controlled-release) is an approved, widely used cervical ripening agent that provides controlled prostaglandin delivery over 12 hours and can be removed if hyperstimulation occurs. Oxytocin is used after cervical ripening or when the cervix is favorable. Misoprostol is also used but with more caution due to risk of tachysystole; dinoprostone has the advantage of retrievability.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.