PART A

CERVIX RIPENING
TEXT A
Cervical ripening is a normal process of softening and opening the cervix before labor starts. The cervix is
stiff and closed through most of pregnancy to hold your baby inside your uterus. But during labor, cervical
dilation (widening) allows your baby to pass through your birth canal. Cervical ripening often happens on
its own, naturally. Some women may benefit from assisted cervical ripening.
This may come in the form of medicines, devices or procedures to ripen the cervix before labor begins
People who have labor induced often benefit from cervical ripening
You might need labor induction and/or cervical ripening if you:
Have an overdue pregnancy (pregnancy that lasts longer than 41 weeks).
Have health risks that threaten your health or the health of the fetus. These may include preeclampsia,
gestational diabetes or growth restriction.
Live far from a hospital and need to plan your labor at a closer location.

TEXT B

Procedure
Your healthcare provider may recommend synthetic (artificial) prostaglandins to ripen your cervix.
Prostaglandins are naturally occurring chemicals in your body that have hormone-like properties. Synthetic
and natural prostaglandins work to soften the cervix and relax cervical muscles, which helps with dilation.
You may receive prostaglandins as a gel, pessary (vaginal insert) or pill. To apply gel, your provider inserts
a catheter containing the gel into your cervix. You might need multiple applications (up to three doses in
24 hours).
You may also receive prostaglandins as a pessary. A pessary is a device that fits into your vagina that
contains prostaglandins. Your vagina absorbs the medicine as its released from the pessary. You might
keep the pessary in for up to 12 hours, or until active labor starts.
Other medications that can ripen the cervix include:
Dinoprostone.
Mifepristone.
Misoprostol.
Oxytocin.
TEXT C
The different cervical ripening techniques carry their own set of risks. The risks of medication are typically
mild, but may include:
Diarrhea.
Fever.
Nausea and vomiting.
Too many contractions (hyperstimulation).
Uterine hyperstimulation is a rare but serious side effect of some labor-inducing medications. They can
cause prolonged or too frequent contractions and can threaten the health of the fetus.
Risks of procedures for cervical ripening may include:
Bleeding.
Drops in fetal heart rate.
Fetal injury or death.
Umbilical cord prolapses (cord drops into the cervix) or compression (cord stretches or gets pressed, so it
doesn’t deliver enough blood to the fetus).

TEXT D
 Time: 15 minutes
● Look at the four texts, A-D, in these separate Text Booklet
● For each question, 1-20, look through the texts, A-D, to find the relevant information.
● Write your answers on the spaces provided in this Question Paper.
● Answer all the questions within the 15-minte time limit.
● Your answers should be correctly spelt.
Cervix Ripening: Questions
Questions 1 - 7
For each question 1 – 7, decide which text (A, B, C or D) the information comes from. You may use any
letter more than once. In which text can you find information about.
1. How do certain labor inducing medications threaten the health of the fetus? ___________

2. How frequently should prostaglandin gel be applied to aid cervical dilation? ___________

3. Various pharmaceutical agents employed for cervical ripening? ___________

4. Under what circumstances might cervical ripening be deemed necessary? ___________

5. Tally of patients who ceased the intervention after the follow-up period concluded? ___________

6. Potential health hazards that endanger both maternal and fetal well-being? ___________

7. Adverse consequences resulting from cervical ripening interventions? ___________

Questions 8 – 14
Answer each of the questions, 8 – 14, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.
8. What consequences in fetal fluid distribution may manifest due to umbilical cord prolapse?
________________________________
9. What pathological state can instigate contractions characterized by prolonged or excessive frequency,
thereby jeopardizing fetal well-being?
________________________________
10. What is the gestational threshold that women must surpass for their pregnancy to be deemed overdue?
________________________________
11. The endogenous compounds in the human body exhibiting properties akin to hormones are called?
________________________________
12. What experienced premature rupture, resulting in patients not receiving their allocated intervention?
________________________________
13. What anatomical structure remains rigid and sealed to securely retain the fetus within the uterine
cavity?
________________________________
14. How many patients demonstrated reluctance to engage in the study?
________________________________

Questions 15 – 20
Complete each of the sentences, 15 – 20, with a word or short phrase from one of the texts. Each answer
may include words, numbers or both.
15. Two main reasons led to the exclusion of _____________ patients out of the 247 initially assessed for

eligibility.

16. For the application of prostaglandin _________________, your healthcare provider inserts a slender,

pliable tube laden with it into your cervical canal.

17. ___________________________________ encompasses the utilization of pharmaceuticals,

instruments, or techniques to ripen the cervix prior to the onset of labor.

18. The occurrence of uterine hyperstimulation may lead to ______________________ that are either

prolonged or overly frequent, thereby endangering the fetal well-being.

19. ____________________ is facilitated by both synthetic and endogenous prostaglandins, which work to

induce softening of the cervix and encourage relaxation of cervical musculature.

20. The potential hazards to maternal or fetal well-being encompass _________________________,

preeclampsia, or growth restriction.

END OF PART A

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