Intrapartum cervical exam

Five parameters are assessed:

1. Dilation
2. Effacement 
3. Station
4. Consistency 
5. Position

Report: cm dilation/ % effacement/ -3 to +3 (or high, low)/ thick or thin/ posterior or anterior 

Dilation: size of opening (0-10cm)

• Index and middle fingers are inserted in the cervical opening and are separated as far as the cervix will allow

• Don't stick your fingers in w/o making sure that the pt does not have placenta previa, vasa previa

Effacement: length of the cervix

• Cervix shortens with labor (when it's shortened by 50% = 50% effacement, about 2cm)
• Palpate w/ finger to estimate the length from internal os to external os

Station: descent in relation to ischial spine

Consistency: firm to soft

Position: location of the cervix w/ respect to the fetal presenting part

• Posterior: difficult to palpate (high in pelvis)
• Anterior: easy to palpate
• During labor, cervical position progresses from posterior to anterior 

BISHOP SCORE

Scoring system that helps to determine the status of the cervix for vaginal delivery based on these 5 parameters 

• Score >= 6: probability of vaginal delivery w/ induction of labor is similar to that of spontaneous labor