SOGC CLINICAL PRACTICE GUIDELINEIt is the Society of Obstetricians and Gynaecologists of Canada(SOGC)policy to review the content 5 years after publication,at whichtime the document may be revised to reflect new evidence or the document may be archived.No.432b,January 2023 (Replaces No.296,September 2013)Guideline No.432b:Cervical Ripening(En francais Directive clinique no 432b Maturation cervicale)The English document is the original version.In the event of any discrepancy between the English and French content,the English version prevails.This dlinical practice guideline was prepared by the authors andDisclosures:Statements were received from all authors.Nooverseen by the SOGC Clinical Practice-Obstetrics Committee.relationships or activities that could involve a conflict of interestIt was reviewed by the SOGC Obstetrical Content Reviewwere declared.All authors have indicated that they meet theCommittee.It was reviewed and approved by the SOGCjournal's requirements for authorship.Guideline Management and Oversight Committee and the SOGCBoard of Directors.Weeks Gestation Notation:The authors follow the World HealthOrganization's notation on gestational age:the first day of the lastThis dinical practice guideline supersedes No.296,published inmenstrual period is day 0 (of week 0);therefore,days 0 to 6September 2013.correspond to completed week 0,days 7 to 13 correspond tocompleted week 1,etc.Authorsdebbie Robinson,MD,Winnipeg,MBKeywords:labour;induced;cervical ripeningKim Campbell,RM,Vancouver,BCCorresponding Author:debbie Robinson,Sebastian R.Hobson,MD,PhD,Toronto,ONdebbie.Robinson@umanitoba.caW.Kim MacDonald,MD,Victoria,BCDiane Sawchuck,RN,PhD,Victoria,BCBrenda Wagner,MD,Vancouver,BCKEY MESSAGE1.Cervical ripening should occur whenever the Bishop score isJ Obstet Gynaecol Can 2023;45(1):56-62less than 7.For outpatient settings,the preferred method ofhtps:ldoi1.og/10.1016 /j.jogc.2022.11.007cervical ripening is the use of a cervical balloon.Whereinsertion of a cervical balloon is not possible.use of2022 The Society of Obstetricians and Gynaecologists of Canada/Laprostaglandin E2 is recommended,which may also be used inSociete des obstetriciens et gynecologues du Canada.Published byan outpatient setting.For individuals requiring inpatientElsevier Inc.All rights reserved.cervical ripening,the preferred options are balloon,oralmisoprostol,or both concumrently.This document reflects emerging clinical and scientific advances as of the publication date and is subject to change.The information is notmeant to dictate an exclusive course of treatment or procedure.Institutions are free to amend the recommendations.The SOGC suggests,however,that they adequately document any such amendments.Informed consent:Patients have the right and responsibility to make informed decisions about their care,in partnership with their health careprovider.In order to facilitate informed choice,patients should be provided with information and support that is evidence-based,cul
