Obstetrics Book

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Bishop Score

Aka: Bishop Score
  1. Scoring
    1. Cervical Dilation
      1. Cervix dilated < 1 cm: 0
      2. Cervix dilated 1-2 cm: 1
      3. Cervix dilated 2-4 cm: 2
      4. Cervix dilated > 4 cm: 3
    2. Cervical Length (Effacement)
      1. Cervical Length > 4 cm (0% effaced): 0
      2. Cervical Length 2-4 cm (0 to 50% effaced): 1
      3. Cervical Length 1-2 cm (50 to 75% effaced): 2
      4. Cervical Length < 1 cm (>75% effaced): 3
    3. Cervical Consistency
      1. Firm cervical consistency: 0
      2. Average cervical consistency: 1
      3. Soft cervical consistency: 2
    4. Cervical Position
      1. Posterior cervical position: 0
      2. Middle or anterior cervical position: 1
    5. Zero Station Notation (presenting part level)
      1. Presenting part at ischial spines -3 cm: 0
      2. Presenting part at ischial spines -1 cm: 1
      3. Presenting part at ischial spines +1 cm: 2
      4. Presenting part at ischial spines +2 cm: 3
  2. Modifiers
    1. Add 1 point to score for:
      1. Preeclampsia
      2. Each prior Vaginal Delivery
    2. Subtract 1 point from score for:
      1. Postdates Pregnancy
      2. Nulliparity
      3. Premature or prolonged Rupture of Membranes
  3. Interpretation
    1. Indications for Cervical Ripening with prostaglandins
      1. Bishop Score <5
      2. Membranes intact
      3. No regular contractions
    2. Indications for Labor Induction with Pitocin
      1. Bishop Score >= 5
      2. Rupture of Membranes

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