Prostaglandins used to ripen the cervix include:

• A. Foley catheter
• B. Misoprostol and dinoprostone
• C. Oxytocin
• D. Amniotic membrane rupture

Answer: (B)

Cervical ripening involves softening, effacement, and dilation of the cervix by a chemical remodeling of the cervical tissue and increased local prostaglandin activity, which helps cervical dilation and makes labor induction more successful. The prostaglandins used for this purpose are misoprostol, a prostaglandin E1 analog, and dinoprostone, a prostaglandin E2 preparation. Misoprostol is versatile and inexpensive and can be given orally or vaginally; dinoprostone is commonly used as a vaginal gel or insert to deliver PGE2 directly to the cervix. The other options represent non-prostaglandin methods: a Foley catheter is a mechanical method to promote dilation; oxytocin induces contractions but does not primarily ripen the cervix; rupturing membranes is a mechanical method that may augment labor but is not a prostaglandin. Therefore, misoprostol and dinoprostone are the prostaglandins used for cervical ripening.