A 31-year-old primigravida at 41 weeks is induced with a Foley catheter for cervical ripening. After 12 hours, the catheter falls out spontaneously, and the cervix is 4 cm dilated and 70% effaced. What is the next step in management?
- A Administer misoprostol
- B Perform cesarean section
- C Perform amniotomy and start oxytocin ✓
- D Wait for spontaneous labor
Correct answer: C. Perform amniotomy and start oxytocin
Explanation
Once the cervix becomes favorable after mechanical ripening, amniotomy and oxytocin augmentation are appropriate to achieve active labor. Misoprostol is used for an unfavorable cervix, which is no longer the case. Cesarean section is not indicated as there is no fetal distress or failed induction. Waiting for spontaneous labor is less efficient when induction is already indicated.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.