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Bishop Scoring System Used For Assessment of Inducibility

Factor

Score

Dilatation (cm)

Effacement (%)

Station

Cervical Consistency

Cervical Position

0

Closed

0-30

-3

Firm

Posterior

1

1-2

40-50

-2

Medium

Mid-position

2

3-4

60-70

-1

Soft

Anterior

3

≥5

>80

+1 to +2

-

-

  1. A score of 9 conveys a high likelihood for a successful induction. Score of 4 or less identifies unfavorable cervix and needs for cervical ripening.
  2. Local application of prostaglandin E2 (dinoprostone) is commonly used for cervical ripening.
  3. ACOG has approved use of 25 flg vaginal misoprostol for cervical ripening. A vaginal dose of 50 μg is associated with tachysystole/meconium passage aspiration.

Important terminologies

 

Lie: It is the relationship between the long axis of the fetal ovoid to the long axis of the uterine ovoid. The lie can be (1) longitudinal, (2) transverse or (3) oblique. The commonest is longitudinal seen in 99.5% cases.
 

Presentation: Is that part of the fetus that lies over the pelvic inlet and occupies the lower pole of the uterus. Presentation can be cephalic, podalic (breech) in case of longitudinal or oblique lie and shoulder (in case of transverse lie).

 

Description: 22


Presenting part:
Is the most dependant part of the fetus, which is felt first on vaginal examination. So in cephalic presentation, the presenting part may be vertex (most common), brow or face, depending upon the degree of flexion. Similarly in breech the fetus may be flexed as in flexed breech (most common), extended at the knees as in extended breech or complete extended as in footling breech.
 

Attitude: Is the relation of the fetal parts to each other. The main attitudes are flexion and extension.

 

Denominator: Is as arbitrarily chosen point on the presenting part of the fetus which is used to describe the position.

 

Presentation

Attitude

Denominator

Cephalic

- Vertex occipitoanterior

- Vertex occipitoposterior

- Brow Extension

- Face Complete extension

Podalic or breech

Shoulder

 

Flexion

Deflexion

Brow

Chin or mentum

 

Acromion

 

Occiput

Occiput

 

 

Sacrum

 





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