Modified Bishop Score for Vaginal Delivery and Induction of Labor

Why Use

Predicting which women will successfully deliver with induction is difficult, and the Bishop Score is a standardized system used for evaluation.

When to Use

Patients being evaluated for labor (including possible induction).

Formula

Pearls / Pitfalls

The Bishop Score was originally developed to predict failure of elective induction in multiparous women. It is commonly considered for predicting the need for caesarean section after induction and preterm labor. Some centers recommend using the Modified Bishop Score which was developed in 1982 as an update to Bishop's original 1964 scoring system. The scoring system was developed prior to cervical ripening agents. Typically a score ≥8 is used to predict success and a score ≤6 suggests an unfavorable cervix.

Advice

Induction is often considered at a Modified Bishop Score of ≥8.

More Information

Score interpretation: Scores ≤ 5 suggest an unfavorable cervix, and that induction may be necessary for successful vaginal delivery. Scores 6-7 do not definitively predict whether or not induction will be successful. Consider induction or augmentation of labor based on clinical judgment. Scores ≥ 8 suggest spontaneous vaginal delivery is more likely and augmentation or induction may be unnecessary.