Modified1 Bishop Score2 to Assess Cervical Favorability

Score
Parameter
0 1 2 3
Dilatation < 1 cm 1 – 2 cm 2 – 4 cm > 4 cm
Length of cervix > 4 cm 2 – 4 cm 1 – 2 cm < 1 cm
Consistency Firm Average Soft
Position Posterior Mid/Anterior
Station –3 –2 –1 / 0 +1 / +2

A score of eight or more generally indicates that the cervix is ripe, or 'favorable' – when there is a high chance of spontaneous
labour, or response to interventions made to induce labour.
1. Wherever induction of labour is carried out, facilities should be available for continuous electronic fetal heart rate and
uterine contraction monitoring3
2. Before induction of labour is carried out, Bishop score should be assessed and recorded, and a normal fetal heart rate
pattern should be confirmed using electronic fetal monitoring3.
3. When contractions begin after induction with PGE2, consider carrying out a vaginal examination
4. Bishop score should be reassessed 6 hours after vaginal PGE2 tablet insertion3 (even when there are no contractions)
Reference:

1. Royal College of Obstetricians and Gynaecologists; RCOG Clinical Effectiveness Support Unit. Induction of labour. Evidence-based Clinical Guideline
Number 9. London: RCOG Press; 2001.
2. Bishop EH. Pelvic scoring for elective induction. Obstetrics and Gynecology 1964;24(2):266 – 8.
3. National Institute for Health and Clinical Excellence. Inducing labour. Clinical Guideline 70. London: NICE; 2008