Bishop Score (Modified)
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Cervical dilation <1 cm 1 - 2 cm 2-4 cm >4 cm
Cervical length >4 cm 2 - 4 cm 1-2 cm <1 cm
Cervical consistency Firm Medium Soft
Cervical position Posterior Mid or Anterior
Fetal station -3 cm -2 cm -1 or 0 cm +1 or +2 cm
R e s u l t s
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Modified Bishop Score
 
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Bishop Score (Modified)

The Modified Bishop Score is a clinical scoring system based upon vaginal examination that assists in predicting whether induction of labor will be needed.

This modification of the original Bishop Score was made by Calder, et al in 1974.

5 components on vaginal exam are used:

  • Cervical dilation
  • Cervical length
  • Cervical consistency
  • Cervical position
  • Fetal station

The score can range from 0 to 12.

  1. Cervical dilation
    • 0 pt = <1 cm
    • 1 pt = 1-2 cm
    • 2 pts = 2-4 cm
    • 3 pts = >4 cm
  2. Cervical length
    • 0 pt = >4 cm
    • 1 pt = 2-4 cm
    • 2 pts = 1-2 cm
    • 3 pts = <1 cm
  3. Cervical consistency
    • 0 pt = Firm
    • 1 pt = Medium
    • 2 pts = Soft
  4. Cervical position
    • 0 pt = Posterior
    • 1 pt = Mid or Anterior
  5. Fetal station
    • 0 pt = -3 cm
    • 1 pt = -2 cm
    • 2 pts = -1 or 0 cm
    • 3 pts = +1 or +2 cm

Interpretation:

The lower the score, the less likely labor will start spontaneously. A score of <5 indicates that labor will not likely commence spontaneously. Scores of 9 or more are consistent with labor likely to commence with no induction.

Reference:

  1. Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-8.
  2. Calder AA, Embrey MP, Hillier K. Exta-amniotic prostaglandin E2 for the induction of labour at term. J Obstet & Gynaecol Br Commonw. 1974;81:39-46.