Bishop Score
Calculates the Bishop score from cervical dilation, effacement, station, consistency and position.
When to use
Assessment of cervical readiness before induction of labor at term.
Pearls and pitfalls
- The total runs from 0 to 13: dilation, effacement and station score 0 to 3 points; consistency and position, 0 to 2.
- Dilation of 5 cm or more, effacement of 80% or more and station at +1 or +2 each score 3 points.
- The score was described in term multiparas with a prior vaginal delivery; nulliparas, preterm births and other induction methods were not validated in the original article.
- Bishop defined elective induction as safe from 9 points; the current adaptation keeps 9 or more as favorable and 5 or less as unfavorable.
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Formula
Sum of the points for dilation, effacement, station, consistency and position, as published in the table.
Evidence
Original Bishop table, reproduced with permission in the 2022 Wheeler review: total from 0 to 13, favorable above 8 and unfavorable at 5 or less. The original study enrolled term multiparas with a prior vaginal delivery and reported safe elective induction from 9 points, without failures and with a mean labor under 4 hours.
References
- Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-268. https://pubmed.ncbi.nlm.nih.gov/14199536/
- Wheeler V, Hoffman A, Bybel M. Cervical ripening and induction of labor. Am Fam Physician. 2022;105(2):177-186. https://www.aafp.org/pubs/afp/issues/2022/0200/p177.html
- Kuba K, Kirby MA, Hughes F, Yellon SM. Reassessing the Bishop score in clinical practice for induction of labor leading to vaginal delivery and for evaluation of cervix ripening. Placenta Reprod Med. 2023;2:8. doi:10.54844/prm.2023.0353
Frequently asked questions
What is Bishop Score?
Calculates the Bishop score from cervical dilation, effacement, station, consistency and position. Assessment of cervical readiness before induction of labor at term.
How is the result calculated?
Sum of the points for dilation, effacement, station, consistency and position, as published in the table.
How should the result be interpreted?
Original Bishop table, reproduced with permission in the 2022 Wheeler review: total from 0 to 13, favorable above 8 and unfavorable at 5 or less. The original study enrolled term multiparas with a prior vaginal delivery and reported safe elective induction from 9 points, without failures and with a mean labor under 4 hours.
What are the sources?
Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-268. Wheeler V, Hoffman A, Bybel M. Cervical ripening and induction of labor. Am Fam Physician. 2022;105(2):177-186. Kuba K, Kirby MA, Hughes F, Yellon SM. Reassessing the Bishop score in clinical practice for induction of labor leading to vaginal delivery and for evaluation of cervix ripening. Placenta Reprod Med. 2023;2:8.