Bishop Score Calculator
Assess cervical readiness for labor induction.
Total Bishop Score
0
Unfavorable Cervix
The cervix may not be ripe. Induction is less likely to be successful, and cervical ripening methods may be considered first.
The Bishop score is a standardized, widely used scoring system in obstetrics to assess the likelihood of a successful labor induction. It evaluates the state of the cervix, providing a quantitative measure of cervical "ripeness." A favorable (or ripe) cervix is more likely to respond to induction agents and progress to a successful vaginal delivery. This calculator is designed for healthcare professionals to quickly and accurately determine the Bishop score, aiding in clinical decision-making and patient counseling.
The Purpose of the Bishop Score
Induction of labor (IOL) is a common obstetric procedure, initiated when the risks of continuing a pregnancy are deemed greater than the risks of delivery. However, inducing labor on an "unfavorable" or "unripe" cervix can lead to a prolonged and difficult labor, increased need for interventions, and a higher rate of Cesarean delivery.
The Bishop score, developed by Dr. Edward Bishop in 1964, was created to predict the success of IOL. A high score correlates with a higher chance of achieving a vaginal delivery, similar to that of spontaneous labor. A low score suggests that the cervix is not yet ready for labor, and cervical ripening agents (such as prostaglandins or mechanical dilators) may be beneficial before starting oxytocin.
The Five Components of the Bishop Score
The score is calculated by summing the points from five components assessed during a digital cervical examination:
- Cervical Dilation (in cm): This measures how open the cervix is. A more dilated cervix indicates that the process of labor has already begun to some extent.
- Closed: 0 points
- 1-2 cm: 1 point
- 3-4 cm: 2 points
- ≥ 5 cm: 3 points
- Cervical Effacement (in %): This refers to the thinning and shortening of the cervix. A cervix that is 100% effaced is completely thinned out.
- 0-30%: 0 points
- 40-50%: 1 point
- 60-70%: 2 points
- ≥ 80%: 3 points
- Fetal Station: This describes the position of the baby's presenting part (usually the head) in relation to the ischial spines of the mother's pelvis. A station of 0 means the head is "engaged" at the level of the spines. Negative numbers indicate the head is above the spines, and positive numbers indicate it is below.
- -3: 0 points
- -2: 1 point
- -1, 0: 2 points
- +1, +2: 3 points
- Cervical Consistency: This describes the texture of the cervix. A cervix that is preparing for labor becomes softer.
- Firm: 0 points (feels like the tip of your nose)
- Medium: 1 point (feels like your chin)
- Soft: 2 points (feels like your earlobe)
- Cervical Position: This describes the orientation of the cervix in the vagina. An anterior cervix is aligned with the vaginal canal, making it more favorable for labor.
- Posterior: 0 points
- Mid-position: 1 point
- Anterior: 2 points
Interpreting the Score
The total score ranges from 0 to 13. A higher score indicates a more favorable cervix.
- A score of 8 or more is generally associated with a high probability of successful induction and vaginal delivery.
- A score of 6 or 7 is often considered equivocal but still favorable.
- A score of 5 or less is considered unfavorable. In these cases, cervical ripening is often recommended prior to administering oxytocin to increase the likelihood of success and reduce the time spent in labor.
Modified Bishop Score
It is important to note that a "modified Bishop score" is often used in clinical practice, particularly for multiparous women (those who have had a previous birth). In this modification, points are added for a history of previous vaginal delivery. This calculator uses the original Bishop score, but clinicians should always apply their clinical judgment and consider factors like parity when making decisions.
Limitations and Clinical Context
While the Bishop score is an excellent predictive tool, it is not perfect. Labor and delivery are complex processes influenced by many factors, including uterine contractility, fetal size and position, and maternal effort. A woman with a low Bishop score may still have a rapid and successful induction, while a woman with a high score might still require a Cesarean section for other reasons.
Therefore, the Bishop score should be used as one piece of the clinical puzzle. It is a tool to guide management and facilitate shared decision-making with the patient, helping to set realistic expectations for the induction process.
Disclaimer: This calculator is intended for use by healthcare professionals or for educational purposes only. It is not a substitute for clinical judgment or a formal medical evaluation. The assessment of the cervix and decisions regarding labor management should only be performed by a qualified healthcare provider.
Enter values to see the results.
The Bishop score is a standardized, widely used scoring system in obstetrics to assess the likelihood of a successful labor induction. It evaluates the state of the cervix, providing a quantitative measure of cervical "ripeness." A favorable (or ripe) cervix is more likely to respond to induction agents and progress to a successful vaginal delivery. This calculator is designed for healthcare professionals to quickly and accurately determine the Bishop score, aiding in clinical decision-making and patient counseling.
The Purpose of the Bishop Score
Induction of labor (IOL) is a common obstetric procedure, initiated when the risks of continuing a pregnancy are deemed greater than the risks of delivery. However, inducing labor on an "unfavorable" or "unripe" cervix can lead to a prolonged and difficult labor, increased need for interventions, and a higher rate of Cesarean delivery.
The Bishop score, developed by Dr. Edward Bishop in 1964, was created to predict the success of IOL. A high score correlates with a higher chance of achieving a vaginal delivery, similar to that of spontaneous labor. A low score suggests that the cervix is not yet ready for labor, and cervical ripening agents (such as prostaglandins or mechanical dilators) may be beneficial before starting oxytocin.
The Five Components of the Bishop Score
The score is calculated by summing the points from five components assessed during a digital cervical examination:
- Cervical Dilation (in cm): This measures how open the cervix is. A more dilated cervix indicates that the process of labor has already begun to some extent.
- Closed: 0 points
- 1-2 cm: 1 point
- 3-4 cm: 2 points
- ≥ 5 cm: 3 points
- Cervical Effacement (in %): This refers to the thinning and shortening of the cervix. A cervix that is 100% effaced is completely thinned out.
- 0-30%: 0 points
- 40-50%: 1 point
- 60-70%: 2 points
- ≥ 80%: 3 points
- Fetal Station: This describes the position of the baby's presenting part (usually the head) in relation to the ischial spines of the mother's pelvis. A station of 0 means the head is "engaged" at the level of the spines. Negative numbers indicate the head is above the spines, and positive numbers indicate it is below.
- -3: 0 points
- -2: 1 point
- -1, 0: 2 points
- +1, +2: 3 points
- Cervical Consistency: This describes the texture of the cervix. A cervix that is preparing for labor becomes softer.
- Firm: 0 points (feels like the tip of your nose)
- Medium: 1 point (feels like your chin)
- Soft: 2 points (feels like your earlobe)
- Cervical Position: This describes the orientation of the cervix in the vagina. An anterior cervix is aligned with the vaginal canal, making it more favorable for labor.
- Posterior: 0 points
- Mid-position: 1 point
- Anterior: 2 points
Interpreting the Score
The total score ranges from 0 to 13. A higher score indicates a more favorable cervix.
- A score of 8 or more is generally associated with a high probability of successful induction and vaginal delivery.
- A score of 6 or 7 is often considered equivocal but still favorable.
- A score of 5 or less is considered unfavorable. In these cases, cervical ripening is often recommended prior to administering oxytocin to increase the likelihood of success and reduce the time spent in labor.
Modified Bishop Score
It is important to note that a "modified Bishop score" is often used in clinical practice, particularly for multiparous women (those who have had a previous birth). In this modification, points are added for a history of previous vaginal delivery. This calculator uses the original Bishop score, but clinicians should always apply their clinical judgment and consider factors like parity when making decisions.
Limitations and Clinical Context
While the Bishop score is an excellent predictive tool, it is not perfect. Labor and delivery are complex processes influenced by many factors, including uterine contractility, fetal size and position, and maternal effort. A woman with a low Bishop score may still have a rapid and successful induction, while a woman with a high score might still require a Cesarean section for other reasons.
Therefore, the Bishop score should be used as one piece of the clinical puzzle. It is a tool to guide management and facilitate shared decision-making with the patient, helping to set realistic expectations for the induction process.
Disclaimer: This calculator is intended for use by healthcare professionals or for educational purposes only. It is not a substitute for clinical judgment or a formal medical evaluation. The assessment of the cervix and decisions regarding labor management should only be performed by a qualified healthcare provider.