Which of the following is a pharmacologic method used to ripen the cervix prior to induction?

• A. Foley catheter
• B. Oxytocin infusion
• C. Cervical massage
• D. Prostaglandins (misoprostol or dinoprostone)

Answer: (D)

Cervical ripening before induction relies on drugs that soften and prepare the cervix, making it more favorable for labor. Prostaglandins such as misoprostol or dinoprostone act on the cervical tissue to remodel the cervix—reducing collagen density, increasing water content, and overall distensibility. This chemical remodeling lowers the resistance to dilation, allowing induction to proceed more smoothly.

The other options are not pharmacologic ripening agents: a Foley catheter is a mechanical method that dilates the cervix by physical pressure and can promote endogenous prostaglandin release; oxytocin stimulates uterine contractions rather than softening the cervix; cervical massage is a nonpharmacologic technique without drug action. Thus, prostaglandins are the pharmacologic choice for ripening.