Calculator Guides
Bishop Score: Labor Induction and Cervical Ripening Guide
The Bishop score quantifies cervical readiness for labor induction across five parameters: dilation, effacement, station, consistency, and position. Score ≥8 = favorable cervix; proceed directly to oxytocin. Score <6 = unfavorable; cervical ripening agent first.
TL;DR: The Bishop score quantifies cervical readiness for labor induction. Score ≥8 = favorable cervix; proceed to oxytocin. Score <6 = unfavorable; cervical ripening agent first. Bishop score has moderate predictive value (AUROC ~0.65–0.75).
Bishop Score Calculation
| Parameter | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Cervical Dilation | Closed | 1–2 cm | 3–4 cm | ≥5 cm |
| Cervical Effacement | 0–30% | 40–50% | 60–70% | ≥80% |
| Fetal Station | −3 | −2 | −1/0 | +1/+2 |
| Cervical Consistency | Firm | Medium | Soft | — |
| Cervical Position | Posterior | Mid | Anterior | — |
Total score: 0–13
Score Interpretation
| Bishop Score | Cervix | Management |
|---|---|---|
| 0–3 | Very unfavorable | Cervical ripening required |
| 4–5 | Unfavorable | Ripening strongly recommended |
| 6–7 | Intermediate | Consider ripening or low-dose oxytocin |
| ≥8 | Favorable | Proceed to oxytocin or amniotomy |
Evidence
Kehila M et al. (2016) compared TVU-CL with Bishop score. TVU-CL is more objective with less inter-rater variability.
Kolkman DGE et al. (2018) found pooled AUROC of 0.66 for vaginal delivery within 24 hours.
References
- Kehila M, et al. J Neonatal Perinatal Med. 2016;9(2):127–131. PMID: 27197935.
- Kolkman DGE, et al. Am J Perinatol. 2013;30(8):625–630. PMID: 23283806.
- Bishop EH. Obstet Gynecol. 1964;24:266–268. PMID: 14199536.