A multigravida at 40+6 weeks undergoes cervical assessment. Bishop score components: cervical dilation 1 cm (score 1), effacement 40% (score 1), consistency firm (score 0), position posterior (score 0), station -3 (score 0). What is the total Bishop score, and what does it predict?

• A Total score = 4; indicates borderline cervix, induction possible with ripening agents
• B Total score = 6; indicates a favorable cervix requiring no pre-induction ripening
• C Total score = 2; indicates an unfavorable cervix with high likelihood of induction failure ✓
• D Total score = 3; indicates moderate favorability, ripening agent optional

Explanation

Bishop score calculation: dilation 1 cm = 1, effacement 40% = 1, consistency firm = 0, position posterior = 0, station -3 = 0; total = 2. A Bishop score ≤ 6 indicates an unfavorable cervix requiring cervical ripening before or during induction; scores ≤ 3 are particularly unfavorable with low induction success rates. Options for cervical ripening include mechanical (Foley catheter, osmotic dilators) or pharmacologic (dinoprostone, misoprostol) methods. A Bishop score ≥ 8 is considered favorable with expected induction-to-delivery interval similar to spontaneous labor.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.