A 31-year-old G3P2 with one previous uncomplicated lower segment cesarean section presents at 39 weeks with a Bishop score of 4 and requires induction for worsening preeclampsia. Which method of cervical ripening is MOST appropriate?
- A Vaginal misoprostol 25 micrograms
- B Transcervical Foley catheter balloon ✓
- C Intracervical dinoprostone gel
- D Mifepristone 200 mg orally
Correct answer: B. Transcervical Foley catheter balloon
Explanation
Prostaglandin preparations carry a significant risk of uterine tachysystole and are relatively avoided for cervical ripening after a previous cesarean because of uterine rupture risk. Mechanical methods such as a transcervical Foley catheter ripen the cervix effectively with a much lower rate of tachysystole, making them the preferred option in this setting. Mifepristone is not used for term cervical ripening in standard practice.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.