Question

A 22-year-old G1 presents at 42 weeks gestation. Her cervix is long and closed. She does not report contractions and states there is good fetal movement. You discuss the benefits of induction at this time versus waiting until she goes into labor spontaneously. She agrees to proceed with an induction. Which of the following means should be used to ripen the cervix in this patient?

1) Artificial rupture of membranes
2) Membrane stripping
3) Oxytocin infusion
4) Prostaglandin E1 tablet
5) RU486 (progesterone antagonist)

Answer 1

To ripen the cervix at 42 weeks gestation with a long and closed cervix, a Prostaglandin E1 tablet should be used. Oxytocin infusion is not optimal for cervical ripening, and RU486 is not indicated for this purpose.

Step-by-step explanation:

The appropriate method to ripen the cervix in a 22-year-old G1 who presents at 42 weeks gestation with a long and closed cervix is using a Prostaglandin E1 tablet. Artificial rupture of membranes and membrane stripping are generally used when the cervix is more favorable. An oxytocin infusion may be used to stimulate contractions but is not the best option for cervical ripening. RU486 is a progesterone antagonist typically used for medical abortions, not cervical ripening in a term pregnancy.