Reference:
- Lecturer (V)
Labor may be induced, most often for post term babies via the use of oxytocic drugs. Augmentation of labor enhances labor in the cases of hypotonic contractions; prolonged labor. To determine the readiness of the woman for induction or augmentation, Bishop scoring is used.
Bishop Scoring
The lowest score is 0, and the highest score is 13 (3, 3, 3, 2, 2). A score of 8 or above permits for induction/augmentation. Lower than 8, the doctor is not allowed to induce/augment labor.
| Criteria | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Cervical Dilatation | 0 | 1-2 | 3-4 | 5-6 |
| Cervical Effacement | 0% to 30% | 40% to 50% | 60% to 70% | 80% or greater |
| Fetal Station | -3 | -2 | -1 to 0 | +1 to +2 |
| Cervical Consistency | Firm | Medium | Soft | --- |
| Cervical Position | Posterior | Middle | Anterior | --- |
- Determining Consistency: Firm (like tip of nose), Medium (like earlobe), Soft (like lips)
- The medicine used to “ripen” the cervix (induce Goodell’s sign) is a prostaglandin gel.
- If ineffective, Cytotec is used: a scored tablet with 100 mcg, usually administered as 1/4th of a tablet (25 mcg)
- If dilatation remains slow, a Laminaria Tent may be used. It is a dried, sterile, cone-shaped seaweed inserted into the cervix, where it absorbs cervical mucus and expands, facilitating dilatation.
- Determining Position: Posteriorly Positioned (cervix pointing to anus), Middle (straight), Anteriorly Positioned (cervix pointing to clitoris)