Bishop Score Calculator

About the Bishop Score Calculator

Score the cervix before induction of labour from a vaginal examination, in either version:

• the Bishop score — dilation, effacement, station, consistency and position, 0 to 13 — with the simplified Bishop score (dilation, effacement and station only, 0 to 9) worked out from the same findings;
• the modified Bishop score in NICE’s guideline — cervical length instead of effacement, and position scored 0 or 1, 0 to 12.

The result is set against the published thresholds: NICE NG207’s 6 or less (pharmacological or mechanical induction) and more than 6 (amniotomy and oxytocin), its 8 or more for a cervix that is generally ready to dilate, and for the original score the American Family Physician’s more than 8 (favourable) and 5 or less (unfavourable). Written for midwives, obstetricians and students; nothing leaves your browser.

Without a pass, the free preview shows the Bishop score in full, with its band, what NICE advises and every threshold that applies; a Pro pass unlocks the simplified score, the whole breakdown and Copy result.

Common uses

• Recording the Bishop score before an induction and choosing between ripening methods and amniotomy with oxytocin, as NICE sets out.
• Reassessing the cervix during induction to follow progress.
• Converting between the original and the modified versions used in different units.
• Learning the scoring system for midwifery and obstetric training.

The Bishop score

• Dilation: closed 0 · 1–2 cm 1 · 3–4 cm 2 · 5 cm or more 3
• Effacement: 0–30% 0 · 40–50% 1 · 60–70% 2 · 80% or more 3
• Station (cm relative to the ischial spines): −3 0 · −2 1 · −1 or 0 2 · +1 or +2 3
• Consistency: firm 0 · medium 1 · soft 2
• Position: posterior 0 · mid 1 · anterior 2

The total runs from 0 to 13. The simplified Bishop score adds only dilation, effacement and station (0 to 9): in 5,610 nulliparous women induced at 37 to 41 weeks, a simplified score above 5 predicted vaginal birth as well as a full score above 8 (positive predictive value 87.7% against 87.0%).

The modified Bishop score

• Dilation: under 1 cm 0 · 1–2 cm 1 · 2–4 cm 2 · over 4 cm 3
• Length of cervix: over 4 cm 0 · 2–4 cm 1 · 1–2 cm 2 · under 1 cm 3
• Station: −3 0 · −2 1 · −1 or 0 2 · +1 or +2 3
• Consistency: firm 0 · average 1 · soft 2
• Position: posterior 0 · mid or anterior 1

The total runs from 0 to 12. The categories are as printed in NICE’s table, where 2 cm and 4 cm sit at the edge of two groups: choose the group that best matches your finding.

Thresholds

• NICE NG207 (UK): with a Bishop score of 6 or less, offer induction with dinoprostone (vaginal tablet, gel or controlled-release system) or low-dose oral misoprostol, and consider a mechanical method such as a balloon catheter if those are not suitable — for example after a previous caesarean birth — or if the woman chooses it. With more than 6, offer amniotomy and an intravenous oxytocin infusion. NICE describes a score of 8 or more as generally indicating that the cervix is ready to dilate, with a high chance of spontaneous labour or of a response to induction.
• American Family Physician (US review of cervical ripening): a Bishop score above 8 is favourable — the chance of a vaginal birth after induction is the same as after spontaneous labour — and 5 or less is unfavourable, when cervical ripening is likely to be needed.
• NICE also asks for the Bishop score to be assessed and recorded before induction and reassessed at intervals to follow progress.

Sources

• NICE guideline NG207, Inducing labour — recommendations 1.3.4 to 1.3.9 and 1.5.1 to 1.5.4, and the definition of the Bishop score
• NICE, Induction of labour: full guideline — appendix B, tables B.1 (Bishop score) and B.2 (modified Bishop score)
• Wheeler V et al. Cervical ripening and induction of labor, American Family Physician — Bishop score table and thresholds
• Laughon SK et al. Using a simplified Bishop score to predict vaginal delivery

Limitations

• The score is only as good as the examination: it is subjective and examiners can disagree.
• It is one input to a decision that also weighs the reason for induction, gestation, parity, a previous caesarean birth, the position of the baby, the membranes and the woman’s preferences.
• The thresholds come from guidance and studies of women at or near term; the American Family Physician and simplified-score thresholds were published for the original score.
• No drug doses are given here: follow the manufacturer’s guidance and local protocols.

Privacy

On this device: nothing is sent

Everything happens in your browser. What you enter or open here is not uploaded or stored by MySmartCoPilot.