Assessment of cervical ripeness

1. A cervical examination should be performed before initiating attempts at labor induction.

2. The modified Bishop scoring system is most commonly used to assess the cervix. A score is calculated based upon the station of the presenting part and cervical dilatation, effacement, consistency, and position.

Modified Bishop Scoring System

0

1

2

3

Dilation, cm

Closed

1-2

3-4

5-6

Effacement, percent

0-30

40-50

60-70

>S0

Station*

-3

-2

-1, 0

+1, +2

Cervical consistency

Firm

Medium

Soft

Position of the cervix

Posterior

Midposi-tion

Anterior

* Based on a -3 to +3 scale.

3. The likelihood of a vaginal delivery after labor induction is similar to that after spontaneous onset of labor if the Bishop score is >8.

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