Bishop score, also Bishop's score, is a pre-labour

Childbirth

Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...

 scoring system to assist in predicting whether induction of labour

Induction (birth)

Labor induction is a method of artificially or prematurely stimulating childbirth in a woman.-Indications:Common suggested reasons for induction include:* Postterm pregnancy, i.e. if the pregnancy has gone past the 42 week mark....

 will be required. It has also been used to assess the odds of spontaneous preterm delivery.

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
  Cervix
  The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
  
   dilation
• Cervical effacement
• Cervical consistency
• Cervical position
• Fetal
  Fetus
  A fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth.In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization.-Etymology and spelling variations:The...
  
   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
Position Position (Obstetrics) In obstetrics, position is the orientation of the fetus in the womb, identified by the location of the presenting part of the fetus relative to the pelvis of the mother...	Posterior	Intermediate	Anterior	-	The position of the cervix varies between individual women. As the anatomical location of the vagina is actually downward facing, anterior and posterior locations relatively describe the 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.
Consistency	Firm	Intermediate	Soft	-	In primigravid women the cervix is typically tougher and resistant to stretching, much like a balloon that has not been previously inflated. 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	0-30%	31-50%	51-80%	>80%	Effacement is a measure of stretch already present in the cervix. It is analogous to stretching a rubber band; as the rubber band is stretched further, it becomes thinner. This is affected by individual variation and previous surgery such as loop excision Loop electrical excision procedure The loop electrosurgical excision procedure is currently one of the most commonly used approaches to treat high grade cervical dysplasia discovered on colposcopic examination. In UK it is known as "large loop excision of the transformation zone" . The procedure has many advantages including low...  for cervical dysplasia Cervical intraepithelial neoplasia Cervical intraepithelial neoplasia , also known as cervical dysplasia and cervical interstitial neoplasia, is the potentially premalignant transformation and abnormal growth of squamous cells on the surface of the cervix. CIN is not cancer, and is usually curable...  or cancer.
Dilation Cervical dilation Cervical dilation is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery...	0 cm	1–2 cm	3–4 cm	>5 cm	Dilation is a measure of the diameter of the stretched cervix. It complements effacement, and is usually the most important indicator of progression through the first stage of labour.
Fetal station	-3	-2	-1, 0	+1, +2	Fetal station describes the position in of the fetus' head in relation to the distance from the ischial spine Ischial spine From the posterior border of the body of the Ischium there extends backward a thin and pointed triangular eminence, the ischial spine, more or less elongated in different subjects.It can serve as a landmark in pudendal anesthesia.-Surfaces:... s, which can be palpated deep inside the posterior vagina (approximately 8–10 cm) 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.

A low Bishop's score often indicates that induction is unlikely to be successful. 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>3 cm, 1>2 cm, 2>1 cm, 3>0 cm.
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
    Pre-eclampsia
    Pre-eclampsia or preeclampsia is a medical condition in which hypertension arises in pregnancy in association with significant amounts of protein in the urine....
    
    
  • 2. Every previous vaginal delivery

• One point is subtracted for:
  • 1. Postdate pregnancy
  • 2. Nulliparity (no previous vaginal deliveries)
  • 3. PPROM; preterm premature (prelabor) rupture of membranes

External links

• Bishop score - fpnotebook.com
• Bishop score - mother-care.ca
• Methods for Cervical Ripening and Induction of Labor - aafp.org