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Obstetrics & Gynaecology Strong — NICE NG207

Bishop Score

Assesses cervical favourability for induction of labour. Score ≥6 predicts successful induction.

How to use & interpret

The Bishop score assesses how favourable the cervix is for induction of labour, scoring cervical dilation, effacement, station, consistency and position. A higher score means a more favourable cervix and a higher chance of successful induction.

Broadly, a score ≥8 suggests the cervix is favourable (induction likely to succeed, comparable to spontaneous labour), while a low score (often <6) suggests cervical ripening (e.g. prostaglandins or a balloon catheter) may be needed first. Thresholds vary by local protocol.

Score interpretation

Unfavourable 0–5

Bishop Score 0–5: Unfavourable cervix. Induction likely to fail or require pre-induction cervical ripening.

→ Pre-induction cervical ripening: vaginal prostaglandin E2 (dinoprostone 3mg ×2, 6h apart) or balloon catheter. Reassess Bishop before starting oxytocin.

Favourable 6–8

Bishop Score 6–8: Favourable cervix. Induction likely to succeed with AROM ± oxytocin.

→ Artificial rupture of membranes (ARM) ± oxytocin infusion. Continuous CTG monitoring once oxytocin started.

Very Favourable 9–13

Bishop Score ≥9: Very favourable cervix. High likelihood of successful vaginal delivery.

→ ARM alone may be sufficient. Oxytocin only if required after ARM. Anticipate relatively rapid labour.

Interpretation bands for the Bishop Score. Apply clinical judgement and local guidance.

Frequently asked questions

What Bishop score is considered favourable?

A score of 8 or more is generally considered favourable for induction; lower scores often prompt cervical ripening before amniotomy/oxytocin, per local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.