Misoprostol, a synthetic PGE1 analog:

■ Can be administered intravaginally or orally

■ Used for cervical ripening and induction

Scalp stimulation is done between decelerations to elicit a reactive acceleration and rule out metabolic acidosis.

The term CPD (cephalopelvic disproportion) has been used to describe a disparity between the size of the maternal pelvis and the fetal head that precludes vaginal delivery. This condition can rarely be diagnosed with certainty and is often due to malposition of the fetal head (i.e., asynclitism).

Fetal lung maturity must be confirmed before elective induction at < 39 weeks' GA, unless lung maturity can be inferred from other maturity criteria (i.e., documented 30 weeks of fetal heart tones or ultrasound at 12 to 20 weeks' GA).

PGE2 gel and vaginal insert:

■ Both contain dinoprostone

■ Used for cervical ripening in women at or near term


The birth of a fetus through incisions in the abdominal wall (laparotomy) and the uterine wall (hysterotomy).

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