II. Criteria: Scoring
- Cervical Dilation
-
Cervical Length (Effacement)
- Cervical Length > 4 cm (0% effaced): 0
- Cervical Length 2-4 cm (0 to 50% effaced): 1
- Cervical Length 1-2 cm (50 to 75% effaced): 2
- Cervical Length < 1 cm (>75% effaced): 3
- Cervical Consistency
- Firm cervical consistency: 0
- Average cervical consistency: 1
- Soft cervical consistency: 2
- Cervical Position
- Posterior cervical position: 0
- Middle or anterior cervical position: 1
- Zero Station Notation (presenting part level)
- Presenting part at ischial spines -3 cm: 0
- Presenting part at ischial spines -1 cm: 1
- Presenting part at ischial spines +1 cm: 2
- Presenting part at ischial spines +2 cm: 3
III. Criteria: Modifiers
- Add 1 point to score for:
- Preeclampsia
- Each prior Vaginal Delivery
- Subtract 1 point from score for:
- Postdates Pregnancy
- Nulliparity
- Premature or prolonged Rupture of Membranes
IV. Interpretation
- Indications for Cervical Ripening with Prostaglandins
- Bishop Score <5
- Membranes intact
- No regular contractions
- Indications for Labor Induction with Pitocin
- Bishop Score >= 5
- Rupture of Membranes
V. Imaging: Transvaginal Ultrasound (Alternative to Bishop Score)
- Cervical Length >28 mm is as effective as Bishop Score to predict need for ripening agents
VI. Resources
- Bishop Score (MDCalc)