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Bishop score
From Wikipedia, the free encyclopedia

Bishop score, also Bishop's score, is a pre-labour scoring system to assist in predicting whether induction of
labour will be required.[1] It has also been used to assess the odds of spontaneous preterm delivery.[2]

Contents
1 Components
2 Scoring
3 Interpretation
4 Modified Bishop score
5 References
6 See also
7 External links

Components
The total score is achieved by assessing the following five components on vaginal examination: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 score that exceeds 8 describes the patient most likely to achieve a successful
vaginal birth. Bishop scores of less than 6 usually require that a cervical ripening method be used before other
methods.

Cervical dilation
Cervical effacement
Cervical consistency
Cervical position
Fetal station

They can be remembered with the mnemonic: Call PEDS For Parturition = Cervical Position, Effacement,
Dilation, Softness; Fetal Station.

Scoring
Each components is given a score of 0-2 or 0-3. The highest possible score is 13.

Bishop score
Parameter\Score 0 1 2 3 Description
The position of the cervix varies between
individual women. As the anatomical location of
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women. As the anatomical location of
the vagina is actually downward facing, anterior
and posterior locations relatively describe the
Position Posterior Intermediate Anterior -
upper and lower borders of the vagina. The
anterior position is better aligned with the uterus,
and therefore there is an increased likelihood of
spontaneous delivery.
In primigravid women the cervix is typically
tougher and resistant to stretching, much like a
balloon that has not been previously inflated.
Consistency Firm Intermediate Soft - Furthermore, in young women the cervix is more
resilient than in older women. With subsequent
vaginal deliveries the cervix becomes less rigid and
allows for easier dilation at term.
Effacement is a measure of stretch already present
in the cervix. It is analogous to stretching a rubber
51- band; as the rubber band is stretched further, it
Effacement 0-30% 31-50% >80%
80% becomes thinner. This is affected by individual
variation and previous surgery such as loop
excision for cervical dysplasia or cancer.
Dilation is a measure of the diameter of the
>5 stretched cervix. It complements effacement, and
Dilation 0 cm 1-2 cm 3-4 cm
cm is usually the most important indicator of
progression through the first stage of labour.
Fetal station describes the position in of the foetus'
head in relation to the distance from the ischial
+1, spines, which can be palpated deep inside the
Fetal station -3 -2 -1, 0
+2 posterior vagina (approximately 8-10cm) as a
bony protrusion. Negative numbers indicate that
the head is further inside, above the ischial spines.

Interpretation
A score of 5 or less suggests that labour is unlikely to start without induction. A score of 9 or more indicates that
labour will most likely commence spontaneously.[3]

A low Bishop's score often indicates that induction is unlikely to be successful[4]. Some sources indicate that only a
score of 8 or greater is reliably predictive of a successful induction.

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>3cm, 1>2cm, 2>1cm, 3>0cm.[5]

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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 for:


1. Existence of pre-eclampsia
2. Every previous vaginal delivery

One point is subtracted for:


1. Postdate pregnancy
2. Nulliparity (no previous vaginal deliveries)
3. PPROM (premature preterm rupture of membranes)

References
1. ^ Bishop EH (August 1964). "Pelvic scoring for elective induction". Obstet Gynecol 24: 266–8. PMID 14199536
(http://www.ncbi.nlm.nih.gov/pubmed/14199536) .
2. ^ Newman RB, Goldenberg RL, Iams JD, et al. (September 2008). "Preterm prediction study: comparison of the
cervical score and Bishop score for prediction of spontaneous preterm delivery"
(http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2728002) . Obstet Gynecol 112 (3):
508–15. doi:10.1097/AOG.0b013e3181842087 (http://dx.doi.org/10.1097%2FAOG.0b013e3181842087) .
PMID 18757646 (http://www.ncbi.nlm.nih.gov/pubmed/18757646) .
3. ^ Tenore J (2003). "Methods for cervical ripening and induction of labor". Am Fam Physician 67 (10): 2123–8.
PMID 12776961 (http://www.ncbi.nlm.nih.gov/pubmed/12776961) . (Incomplete) Free Text
(http://www.aafp.org/afp/20030515/2123.html) .
4. ^ Cat.Inist (http://cat.inist.fr/?aModele=afficheN&cpsidt=2381313)
5. ^ Dutta DC. Text Book of Obstetrics. 6ed. New Central Book Agency. 2001. ISBN 978-81-7381-142-5.

See also
List of obstetric topics
Fetal fibronectin (fFN)

External links
Bishop score (http://www.fpnotebook.com/OB32.htm) - fpnotebook.com
Bishop score (http://www.mother-care.ca/bishop.htm) - mother-care.ca
Methods for Cervical Ripening and Induction of Labor (http://www.aafp.org/afp/20030515/2123.html) -
aafp.org
Retrieved from "http://en.wikipedia.org/wiki/Bishop_score"
Categories: Obstetrics

This page was last modified on 19 October 2010 at 11:03.


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