Time Specific Content Teacher AV Aids Evaluation

objectives learning
activity

INTRODUCTION
Student will be Student Introduce
able to introduce
The Bishop score is a system used by medical professionals to decide teacher will bishop score ?
the topic how likely it is that you will go into labor soon. They use it to introduce the
determine whether they should recommend induction, and how likely topic with the
it is that an induction will result in a vaginal birth. help of
discussion
method
The Bishop score is a system used by medical professionals to decide
how likely it is that you will go into labor soon. They use it to
determine whether they should recommend induction, and how likely
it is that an induction will result in a vaginal birth.

DEFINITION
Student will be Student Define bishop
able to define Bishop's score, also known as cervix score is a pre-labor scoring teacher will score ?
terminology system to assist in predicting whether induction of labor will be define the term
bishop score required. It has also been used to assess the likelihood of bishop score
with the help
spontaneous preterm delivery. The Bishop Score was developed by of ppt
Professor Emeritus of Obstetrics and Gynecology, Dr. Edward
Bishop, and was first published in August 1964.

COMPONENTS Student Enlist the

Student will be teacher will component of
able to enlist the The total score is calculated by assessing the following five enlist the bishop score ?
component of components on manual vaginal examination by a trained component of
bishop score professional: bishop score
with the help
of ppt
 Dilation of the cervix. This means how far your cervix has
opened in centimeters.

Effacement of the cervix. This means how thin your cervix is. It
is normally about 3 centimeters long. It gradually becomes thinner as
labor progresses.

Effacement of the cervix. This means how thin your cervix is. It
is normally about 3 centimeters long. It gradually becomes thinner as
labor progresses.

Position of the cervix. As the baby descends into the pelvis, the
cervix — the doorway to the uterus — moves forward with the head
and the uterus.

Fetal station. This is how far up the birth canal the baby’s head
is. Usually, before labor begins, the baby’s head moves from –5
(high up and not yet in the pelvis) to station 0 (where the baby’s head
is firmly in the pelvis). During labor the baby moves through the
vaginal canal until the head is clearly visible (+5) and the baby is
about to be delivered.

The Bishop score grades patients who would be most likely to

achieve a successful induction. The duration of labor is inversely
correlated with the Bishop score; a score that exceeds 8 describes the
patient most likely to achieve a successful vaginal birth. Bishop
scores of less than 6 usually require that a cervical ripening method
(pharmacologic or physical, such as a foley bulb) be used before
other methods.
 Scoring Explain the
Student will able Student scoring in
to explain the The examiner assigns a score to each component of 0 to 2 or 0 to 3. teacher will bishop score?
scoring in bishop The highest possible score is 13 and the lowest possible score is 0. explain the
score scoring in
bishop score
with the help
Bishop score of ppt and
Score lecture cum
Parameter Description discussion
0 1 2 3
The position of the
cervix changes with
menstrual cycles and
also tends to become
Cervical
Posterior Middle Anterior – more anterior (nearer
position
the opening of the
vagina) as labour
becomes closer.

In primigravid
women, the cervix is
typically tougher and
resistant to
stretching, much like
Cervical a balloon that has not
Firm Medium Soft –
consistency been previously
inflated (it feels like
the bottom of a chin).
With subsequent
vaginal deliveries,
the cervix becomes
 less rigid and allows
for easier dilation at
term.

Effacement translates
to how 'thin' the
cervix is. The cervix
is normally
approximately three
Cervical
0-30% 40-50% 60-70% 80+% centimetres long, as
effacement
it prepares for labour
and labour continues
the cervix will efface
till it is 'fully effaced'
(paper-thin).
Dilation is a measure
of how open the
cervical os is (the
hole). It is usually
Cervical the most important
Closed 1–2 cm 3–4 cm 5+cm
dilation indicator of
progression through
the first stage of
labour.

Fetal station
describes the
Fetal +1, position of the fetus's
−3 −2 −1, 0
station +2 head in relation to
the distance from the
ischial spines, which
 are approximately 3-
4 centimetres inside
the vagina and are
not usually felt.
Health professionals
visualise where these
spines are and use
them as a reference
point. Negative
numbers indicate that
the head is further
inside than the
ischial spines and
positive numbers
show that the head is
below the level of the
ischial spines.

Interpretation
Student will be Student Describe the
able to describe A Bishop's score 6 or less often indicates that induction (e.g., with teacher will interpretation
the interpretation controlled-release prostaglandin E2/prostin gel [Cervidil], describe the in bishop score
in bishop score intravaginal gel [Prostin], intracervical gel [Prepidil]) is unlikely to interpretation ?
in bishop score
be successful. Some sources indicate that only a score of 8 or greater
with the help
is reliably predictive of a successful induction. of ppt and
lecture-cum-
discussion

Modified Bishop score

 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 Student Explain the
Student will be Cervical length may be easier and more accurate to measure and teacher will modified
able to explain have less inter-examiner variability. explain the bishop score ?
the modified modifiedbishop
bishop score Another modification for the Bishop's score is the modifiers. Points score with the
help of ppt and
are added or subtracted according to special circumstances as
lecture-cum-
follows: discussion

 One point is added to the total score for:

o 1. Existence of pre-eclampsia
o 2. Each previous vaginal delivery
 One point is subtracted from the total score for:
o 1. Postdate/post-term pregnancy
o 2. Nulliparity (no previous vaginal deliveries)
o 3. PPROM; preterm premature (prelabor) rupture of
membranes

Uses
Bishop score can help patient and the healthcare provider
understand labor progression. The score may also be used to help
determine whether you are a good candidate for labor induction.

If labor doesn’t start spontaneously before 42 weeks, then there are

risks involved both in waiting for labor to start and in having your
labor medically induced. The healthcare provider should be able to
provide you with all the evidence you need to weigh the risks and
benefits and make an informed decision about what is right for you
and your baby.
SUMMARY
Today we discussed about the bishop score which include:-
 Introduction
 Definition
 Component
 Scorning
 Interpretation
 Modified bishop score
 Uses

CONCLUSION
we all conclude from the topic about the bishop score there uses and
there component . In this topic we had look after over all.
 PANNA DHAI MAA SUBHARTI NURSING COLLEGE

LESSON PLAN
ON
BISHOP SCORE

SUBMITTED TO:- SUBMITTED BY:-

GENERAL OBJECTIVE :-At the end of the lecture student will be able to explain bishop score and apply this knowledge in
clinical practice

STUDENT CENTRED SPECIFIC OBJECTIVES :-At the end student will be able to:-
 define the term bishop score
 enlist the component of bishop score
 explain the scoring in bishop score
 describe the interpretation in bishop score
 explain the modified bishop score
LESSON PLAN

Name of the student teacher:-

Lesson plan topic:-
Unit:-
Subject:-
Venue:-
Date:-
Time:-
Group involved:-
Student strength:-
Method of teaching:-
A.V aids:-
Evaluator:-
REFERENCE:

 Jacob A.A,Comprehensive Textbook of Midwifery and Gynecological Nursing,3rd edition,New Delhi, Jaypee;2012, Pageno.225-
230.

 Fraser DM, Cooper MA.Myles,Textbook for Midwives,15th edition, Philadelphia:churchilllivingstone elsevier;2009

 Dutta DC,Textbook of Obstetric,6th edition, New central book agency, Calcutta,2004, Page no.220-245
 Marriner TA, Raile AM. Nursing theorists and their work. 5th ed. St Louis: Mosby; 2005
 George BJ, Nursing Theories- The Base for Nursing Practice.3rd ed. Chapter 8. Lobo ML. Behavioral System Model. St Louis:
Mosby; 2005
 Alligood MR “Nursing Theory Utilization and Application” 5th ed. St Louis: Mosby; 2005
 Black JM, Hawks JH, Keene AM. Medical surgical nursing. 6th ed. Philadelphia: Elsevier Mosby; 2006.
 Brunner LS, Suddharth DS. Text book of Medical Surgical Nursing. 6th ed. London: Mosby; 2002
 Boon NA, Colledge NR, Walker BR, Hunter JAA. Davidson’s principle and practices of medicine. 20th ed. London: Churchill
Livingstone Elsevier; 2006.
 K.D Triphati, textbook of pharmacology.10th edition. churchilllivingstoneelsevier

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