A 31-year-old G3P2 with one previous lower segment caesarean section presents at 39 weeks with an unfavourable cervix (Bishop score 4) requiring induction for mild preeclampsia. Which method of cervical ripening is MOST appropriate?
- A Vaginal misoprostol 25 mcg six-hourly
- B Dinoprostone controlled-release pessary
- C Transcervical Foley catheter balloon ✓
- D Immediate repeat caesarean section
Correct answer: C. Transcervical Foley catheter balloon
Explanation
Prostaglandins are relatively contraindicated for cervical ripening after a previous caesarean because they increase the risk of uterine scar rupture. Mechanical methods such as a transcervical Foley catheter ripen the cervix without increasing uterine tone and are the recommended choice in this setting. Repeat caesarean is not required since the indication is mild preeclampsia at term and vaginal birth remains reasonable under supervised induction.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.