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The modified Bishop score was used to assess all patients admitted for induction of labour.
The risk doubled with a Bishop score less than 5 at the time of admission, compared with higher Bish-op scores.
When bundle achievers were grouped by Bishop score, those with a poor Bishop score had higher rates of cesarean, more neonates to special care, longer lengths of labor, and higher rates of cesarean for dystocia and poor fetal heart rate pattern.
Two-thirds were nulliparous, and most (83%) had a Bishop score of 3 or less.
A woman who gets to 42 weeks' gestation who hasn't already done anything on her own already has two strikes against her; her Bishop score is 2, and a 3-day induction may not make it.
In nulliparous women, the increment in the Bishop score from catheter insertion until withdrawal or expulsion was significantly higher at a mean of 4.
ACOG 2004 guidelines permit elective inductions only after 39 weeks, advise that the procedure be done in nulliparas only if the Bishop score is 8 or more (and in multiparas only if the Bishop score is 6 or more), and do not allow the use of cervical ripening.
Doses were given every 3-6 hours in both groups, until a Bishop score of at least 7, labor, intervention, or a total of six misoprostol doses.