Bishop Score

Predicts whether successful vaginal delivery is likely or labor needs to be induced based on the original and the modified versions.

In the text below the calculator there is more information on the two scoring methods, the original and modified Bishop scores.


This Bishop score is used in obstetrics and gynecology as an assessment method of labor.

It checks whether succesful vaginal delivery is likely to happen or if intervention is required, based on dilatation and other cervix factors.

There is a mnemonic for the factors used in the assessment: “Call PEDS For Parturition = Cervical Position, Effacement, Dilation, Softness; Fetal Station.”


This is the Bishop score interpretation:

■ Scores below 5 indicate that labor inducement may be required.

■ Scores between 5 and 9 may indicate either successful labor or need for inducement.*

■ Scores above 9 indicate high chances of successful vaginal birth.

* In these cases, other factors (such as membrane rupture or contraction frequency) are considered.


1

Dilation (cm)

2

Effacement (%)

3

Station

4

Consistency

5

Position

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1

Dilation (cm)

2

Effacement (%)

3

Station

4

Consistency

5

Position

6

Prior vaginal deliveries

7

Select what other characteristics may apply:

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About Bishop score

This is a score used to determine the possibility of successful vaginal delivery or the need for induced labor.

In some cases, this pelvic or cervix score helps calculate pre-term delivery odds. This model was created in the early 60s by Dr. Edward Bishop.

There are two circulating versions of the score, the original one and a modified one, the items of which can be found in the table below, along their weight in the total score:

Bishop score items Answer choices (points)
Dilation (cm) Closed (0)
1 – 2 cm (1)
3 – 4 cm (2)
+5 cm (3)
Effacement (%) 0 – 30% (0)
40 – 50% (1)
60 - 70% (2)
80% (3)
Station -3 (0)
-2 (1)
-1, 0 (2)
+1, +2 (3)
Consistency Firm (0)
Medium (1)
Soft (2)
Position Posterior (0)
Mid (1)
Anterior (2)
Additional items (featured in the modified Bishop score):
Prior vaginal deliveries Each pregnancy counts as 1 point in score
Select what other characteristics may apply: Preeclampsia (1)
Postdates pregnancy (-1)
Nulliparity (-1)
Premature or prolonged rupture of membranes (-1)

Cervical dilation for delivery is at 10 cm. Minor dilation occurs in some cases days or even weeks before start of labor.

Cervical effacement represents the degree of softening and thinning of the cervix, measured during cervical exam.

Normally effaced cervix is classed as 0%. 50% effacement is when the cervix is half of its original thickness. Vaginal delivery occurs at 100% cervical effacement.

Fetal station describes the descent of the baby into the pelvis. An imaginary line drawn between the two extremities of the pelvic bones is used to assess the fetal position.

When the baby is above the line this marks minus station. When the baby is below the line, this marks plus station.

 

Score interpretation

As a pre-labor scoring system, the Bishop score offers information as to whether medical inducement of labor is required.

The scores range from 13 to 0, although the latter is highly unlikely. The sum of points awarded to each of the pregnancy associated factors is interpreted as follows:

■ Scores above 9 points indicate high likelihood of successful vaginal birth.

■ Scores between 5 and 9 carry both indication of induced or spontaneous labor. In these cases, the outcome is dependent on other patient factors such as regular contractions or membrane rupture presence.

■ Scores below 5 indicate that intervention with a cervical ripening method is likely to be required to induce labor.

There is a correlation between Bishop scores and caesarean rates. These values differ for first time mothers and women with past vaginal deliveries:

Bishop score First time mother (nulliparous) Past vaginal delivery (multiparous)
0 - 3 45% 7.70%
4 - 6 10% 3.90%
7 - 10 1.40% 0.90%
 

Original source

Bishop EH. Pelvic Scoring For Elective Induction. Obstet Gynecol. 1964; 24:266-8.

Other references

1. Laughon SK. et al. Using a Simplified Bishop Score to Predict Vaginal Delivery. Obstet Gynecol. 2011; 117(4): 805–811.

2. Crane JM. Factors predicting labor induction success: a critical analysis. Clin Obstet Gynecol. 2006; 49(3):573-84.


App Version: 1.0.1

Coded By: MDApp

Specialty: Obstetrics Gynecology

System: Reproductive

Objective: Prediction

Type: Score

No. Of Items: 5 or 7

Year Of Study: 1964

Article By: Denise Nedea

Published On: May 17, 2017 · 10:51 AM

Last Checked: May 17, 2017

Next Review: May 17, 2018