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Modified Bishop score [ edit ] According to the Modified Bishop's pre-induction cervical scoring system, effacement has been replaced by cervical length in cm, with scores as follows: 0 for >3 cm, 1 for >2 cm, 2 for >1 cm, 3 for >0 cm. [ 6 ] Cervical length may be easier and more accurate to measure and have less inter-examiner variability.
Cervical effacement is an important component of the Bishop score and is reported as a percentage. 0% indicates the cervix is at normal length, 50% indicates the cervix is half of the expected length and 100% effaced means the cervix is paper thin. [10] The Bishop score has been modified in current medical practice.
In order to do this, the cervix must be checked to see how much it has effaced, thinned out, and how far dilated it is. The score goes by a points system depending on five factors. Each factor is scored on a scale of either 0–2 or 0–3, any total score less than 5 holds a higher risk of delivering by caesarean section. [27]
The Bishop score can also be used as a means to predict the success of an induction of labour. During effacement, the cervix becomes incorporated into the lower segment of the uterus. During a contraction, uterine muscles contract causing shortening of the upper segment and drawing upwards of the lower segment, in a gradual expulsive motion. [ 47 ]
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Another policy commonly used by 4.0-scale schools is to mimic the eleven-point weighted scale (see below) by adding a .33 (one-third of a letter grade) to honors or advanced placement class. (For example, a B in a regular class would be a 3.0, but in honors or AP class it would become a B+, or 3.33).