From the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Obstet Gynecol. 2011 Apr;117(4):805-811. doi: 10.1097/AOG.0b013e3182114ad2.
The Bishop score is the most commonly used method to assess the readiness of the cervix for induction. However, it was created without modern statistical methods. Our objective was to determine whether a simplified score can predict vaginal delivery equally well.
Data were analyzed for 5,610 nulliparous women with singleton, uncomplicated pregnancies between 37 0/7 and 41 6/7 weeks of gestation undergoing labor induction. These women had all five components of the Bishop score recorded. Logistic regression was performed and a simplified score created with significant components. Positive and negative predictive values and positive likelihood ratios were calculated.
In the regression model, only dilation, station, and effacement were significantly associated with vaginal delivery (P<.01). The simplified Bishop score was then devised using these three components (range 0-9) and compared with the original Bishop score (range 0-13) for prediction of successful induction, resulting in vaginal delivery. Compared with the original Bishop score (greater than 8), the simplified Bishop score (greater than 5) had a similar or better positive predictive value (87.7% compared with 87.0%), negative predictive value (31.3% compared with 29.8%), positive likelihood ratio (2.34 compared with 2.19), and correct classification rate (51.0% compared with 47.3%). Application of the simplified Bishop score in other populations, including indicated induction and spontaneous labor at term and preterm, were associated with similar vaginal delivery rates compared with the original Bishop score.
The simplified Bishop score comprised of dilation, station, and effacement attains a similarly high predictive ability of successful induction as the original score.
II.
Bishop 评分是评估宫颈引产准备情况最常用的方法。然而，它是在没有现代统计方法的情况下创建的。我们的目的是确定简化评分是否可以同样很好地预测阴道分娩。
对 5610 名初产妇进行了数据分析，这些产妇的单胎、无并发症妊娠处于 37 0/7 至 41 6/7 孕周，正在进行引产。这些女性的 Bishop 评分的所有五个组成部分都有记录。进行了逻辑回归，并创建了一个具有显著成分的简化评分。计算了阳性和阴性预测值以及阳性似然比。
在回归模型中，只有扩张、位置和消失与阴道分娩显著相关（P<.01）。然后，使用这三个组成部分（范围 0-9）设计了简化的 Bishop 评分，并将其与原始 Bishop 评分（范围 0-13）进行比较，以预测成功引产和阴道分娩。与原始 Bishop 评分（大于 8）相比，简化的 Bishop 评分（大于 5）具有相似或更好的阳性预测值（87.7%比 87.0%）、阴性预测值（31.3%比 29.8%）、阳性似然比（2.34 比 2.19）和正确分类率（51.0%比 47.3%）。简化 Bishop 评分在其他人群中的应用，包括有指征的引产、足月和早产时的自发性分娩，与原始 Bishop 评分相比，阴道分娩率相似。
由扩张、位置和消失组成的简化 Bishop 评分与原始评分一样具有很高的预测引产成功能力。
II。
