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Bishop Score

The Bishop Score is a predictive score that determines when during Childbirth, the mother is expected to transition to stage II.

It also helps determine if induction of labor is required. Vaginal examination is required for this assessment.

5 Aspects of Cervical Assessment

1.)  Cervical dilation
2.)  Cervical effacement
3.)  Cervical consistency
4.)  Cervical position
5.)  Fetal station

Cervical Dilation

–  This is the diameter of the stretched Cervix
–  It is often seen with effacement
–  It is important in the progression of labor

Cervical Effacement

–  Measures the stretching of the cervix
–  The thinner the better for birth
–  Can be affected by personal issues such as Cancer and previous surgery

Cervical Consistency

–  First time vaginal births have a harder or tougher cervix
–  Younger women have tougher cervix
–  Increased deliveries cervix becomes less rigid – allows for easier dilation

Cervical Position

–  Positioning of Cervix varies
–  Vagina is typically facing downward.
–  From the position it may be more anterior or posterior facing
–  Anterior is better positioned for delivery on it own

Fetal Station

–  Describes the position of the head of the fetus
–  Negative numbers indicate the head remains inside the birthing canal
–  Positive numbers indicate the head is further outside the birthing canal

Readings

0-5  – The spontaneous is unlikely – ripen cervix prior to induction

6-8  – Spontaneous birth is less likely but still may occur in some cases – usually induction occurs in these patients

9 or more  – Spontaneous birth is likely without the need for induction

Added points:

1.)  Preeclampsia
2.)  Each prior vaginal delivery

Points taken away:

1.)  Postdate pregnancies
2.)  Premature or prolonged rupture of membranes
3.)  First time vaginal deliveries

Alternative Scores

*** – Some scores add in 2 additional factors

1.) Vaginal Secretion
2.)  Contractions

Therefore, the numbers mentioned above would change

7 and below:  would require ripening of cervix prior to induction

9-11:  Induction is a great option

12 and above:  Spontaneous birth usually occurs without induction