A 30-year-old woman, G1P0, at 38 weeks gestation is noted to have a Bishop score of 3. She requires induction of labour for gestational hypertension. Which of the following agents is MOST appropriate for cervical ripening before induction?
- A Intravenous oxytocin
- B Dinoprostone (PGE2) vaginal insert ✓
- C Mifepristone
- D Ergometrine
Correct answer: B. Dinoprostone (PGE2) vaginal insert
Explanation
A Bishop score of ≤6 indicates an unfavourable cervix requiring ripening before induction. Prostaglandin E2 (dinoprostone) vaginal insert is a first-line agent for cervical ripening in term pregnancies. Intravenous oxytocin alone is less effective on an unfavourable cervix and does not ripen the cervix directly. Ergometrine is a uterotonic used postpartum for haemorrhage, not for induction.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.