Bishop Score Calculator
Assess cervical favourability for labor induction. Calculates the classic Bishop Score across 5 parameters: dilation, effacement, fetal station, consistency, and cervical position.
Cervical Dilation
Cervical Effacement
Fetal Station
Cervical Consistency
Cervical Position
Bishop Score
0/13
Unfavourable Cervix
Recommendation
Cervical ripening required. Options: PGE2 (Dinoprostone gel/Cerviprime), PGE1 (Misoprostol 25mcg vaginal q4-6h or 50mcg oral), Foley catheter, hygroscopic dilators (Dilapan-S). Reassess Bishop score after ripening.
OBGYN labor management — built for Indian hospitals
From admission to discharge, EasyClinic tracks Bishop scores, partograms, oxytocin doses, fetal heart rate trends, ANC continuity, and generates birth certificates. Trusted by maternity hospitals across India.
Also Known As
What is the Bishop Score?
The Bishop Score, developed by Dr. Edward Bishop in 1964, is the most widely-used scoring system to assess cervical favourability for induction of labor (IOL). It evaluates 5 parameters: cervical dilation, effacement, fetal station, cervical consistency, and cervical position — totalling 0-13.
A higher Bishop score = more favourable cervix = higher chance of successful vaginal delivery after induction. A score ≥9 has a vaginal delivery rate similar to spontaneous labor; a score ≤5 indicates an "unripe" cervix that needs cervical ripening before induction.
Cervical Ripening Methods Used in India
- PGE2 (Dinoprostone) gel — Cerviprime, Prepidil: 0.5 mg intracervical, repeat after 6 hours (max 3 doses)
- PGE1 (Misoprostol): 25 mcg vaginal q4-6h OR 50 mcg oral q4h. Off-label but very effective and cheap
- Foley catheter (Mechanical): 18F catheter with 30-60 mL saline balloon at internal os, removed at 12h or spontaneously
- Dilapan-S (Hygroscopic dilator): 4 rods × 6.5 cm — gentle mechanical dilation
- Membrane sweep (stretch & sweep): Outpatient procedure to release endogenous prostaglandins
Induction Method Selection by Bishop Score
- Bishop ≤5 (Unfavourable): Cervical ripening first → reassess Bishop → ARM + oxytocin
- Bishop 6-8 (Intermediate): ARM + low-dose oxytocin (start 2 mU/min, titrate)
- Bishop ≥9 (Favourable): ARM + oxytocin (or even oxytocin alone for multips)
Frequently Asked Questions
▸When should I induce labor?
Common indications: post-dates (≥41 weeks), gestational diabetes, hypertension/PIH, IUGR, oligohydramnios, prolonged ROM, intrauterine death, maternal medical conditions worsening pregnancy.
▸What is the modified Bishop score?
The modified Bishop score (used in some hospitals) simplifies scoring and replaces consistency/position with cervical length on transvaginal scan. Predictive value similar to original.
▸What if Bishop score is low but induction is necessary?
Use cervical ripening (PGE2 gel, misoprostol, or Foley catheter) for 12-24 hours, then reassess. Most cervices ripen successfully. Counsel about higher cesarean risk if cervix remains unfavourable.
▸Is misoprostol safe for induction in India?
Yes — endorsed by FOGSI and WHO. Use low-dose vaginal (25 mcg q4-6h) or oral (50 mcg q4h). Avoid in previous CS or grand multipara due to uterine rupture risk.
▸How often should I reassess Bishop score?
After each ripening intervention (every 6-12 hours) and before progressing to active induction with oxytocin.
References
- Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol 1964;24:266-8
- ACOG Practice Bulletin No. 107: Induction of Labor (2009, reaffirmed)
- FOGSI Recommendations on Induction of Labor (India)
Stop scribbling Bishop scores in your labor ward notebook
EasyClinic's OBGYN labor module auto-calculates Bishop score every 4 hours, generates partograms, tracks oxytocin titration, and produces complete delivery notes — all hands-free.