Bishop score, also Bishop's score or cervix score, is a pre-

labor Labour or labor may refer to: * Childbirth, the delivery of a baby * Labour (human activity), or work ** Manual labour, physical work ** Wage labour, a socioeconomic relationship between a worker and an employer ** Organized labour and the labour ...

scoring system to assist in predicting whether

induction of labor Labor induction is the procedure where a medical professional starts the process of labor ( giving birth) instead of letting it start on its own. Labor may be induced (started) if the health of the mother or the baby is at risk. Induction of lab ...

will be required. It has also been used to assess the likelihood of spontaneous preterm delivery. The Bishop score was developed by Professor Emeritus of Obstetrics and Gynecology, Edward Bishop, and was first published in August 1964.

Components

The total score is calculated by assessing the following five components on manual vaginal examination by a trained professional: * Cervical dilation in centimeters *

Cervical effacement Cervical effacement or cervical ripening refers to the thinning and shortening of the cervix. This process occurs during Childbirth, labor to prepare the cervix for dilation to allow the fetus to pass through the vagina. While this is a normal, ph ...

as a percentage *Cervical consistency by provider assessment/judgement *Cervical position *

Fetal A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic stage, the fetal stage of development takes place. Prenatal development is a ...

station, the position of the top of the fetal head in relation to the pelvic bones, specifically the ischial spines. The Bishop score grades patients who would be most likely to achieve a successful induction. The duration of labor is inversely correlated with the Bishop score; “A Bishop score of 9 conveys a high likelihood for a successful induction. For research purposes, a Bishop score of 4 or less identifies an unfavorable cervix and may be an indication for cervical ripening.” Excerpt From Williams Obstetrics, 25th Edition F. Gary Cunningham, Kenneth J. Leveno, Steven L. Bloom, Jodi S. Dashe, Barbara L. Hoffman, Brian M. Casey and Catherine Y. Spong This material may be protected by copyright. They can be remembered with the mnemonic: ''Call PEDS For

Parturition Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...

'' = Cervical Position, Effacement, Dilation, Softness; Fetal Station.

Scoring

The examiner assigns a score to each component of 0 to 2 or 0 to 3. The highest possible score is 13 and the lowest possible score is 0.

Interpretation

A score of 5 or less suggests that labour is unlikely to start on its own during the next few days. A score of 9 or more indicates that labour will most likely commence spontaneously in the next few days. Scores between 5 and 9 require additional consideration and professional judgement for clinical management. A Bishop's score 6 or less often indicates that induction (e.g., with controlled-release prostaglandin E2/prostin gel ervidil intravaginal gel rostin intracervical gel repidil is unlikely to be successful. Some sources indicate that only a score of 8 or greater is reliably predictive of a successful induction. The score can be recalculated as the pregnancy progresses.

Modified Bishop score

According to the Modified Bishop's pre-induction cervical scoring system, effacement has been replaced by cervical length in cm, with scores as follows: 0 for >3 cm, 1 for >2 cm, 2 for >1 cm, 3 for >0 cm.Dutta DC. Text Book of Obstetrics. 6ed. New Central Book Agency. 2001. . Cervical length may be easier and more accurate to measure and have less inter-examiner variability. Another modification for the Bishop's score is the modifiers. Points are added or subtracted according to special circumstances as follows: * One point is added to the total score for: ** Existence of

pre-eclampsia Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the new onset of hypertension, high blood pressure and often a significant amount of proteinuria, protein in the urine or by the new onset of high blood pressure a ...

** Each previous delivery * One point is subtracted from the total score for: ** Postdate/post-term pregnancy ** Nulliparity (no previous vaginal deliveries) ** PPROM; preterm premature (prelabor) rupture of membranes

References

External links