Which of the following is not a component of Bishop's score?

Appeared in: HPSSC - 2015

Explanation

The Bishop's score is a pre-labor scoring system used to predict the potential success of labor induction by assessing the state of the cervix.
It comprises five specific components related to the cervix and fetal position: cervical dilatation, effacement, station, consistency, and position.
Uterine contractions, which measure the activity of the uterine muscle, are a sign of labor itself but are not a parameter included in the Bishop's score for assessing cervical favorability.

Option A: Effacement, which is the thinning and shortening of the cervix, is a primary component of the Bishop's score and is scored from 0 to 3 based on its percentage.
Option C: Cervical dilatation, measured in centimeters, is a fundamental parameter of the Bishop's score, indicating how open the cervix is. It is scored from 0 to 3.
Option D: The station of the fetal head, which describes its level in relation to the maternal ischial spines, is a key component of the Bishop's score, scored from 0 to 3.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Components of the Bishop's score as background academic context rather than a clinical decision trigger.
Nurses use the Bishop score to communicate cervical status and anticipate the need for cervical ripening agents (like prostaglandins or a Foley catheter) versus proceeding directly to oxytocin for labor induction.
A low score (e.g., less than 6) alerts the nurse that the induction process may be long and that the patient may require more support and monitoring for cervical change.
What if? - If a patient has a Bishop score of 4 but is having regular, strong contractions, the plan would likely shift. While the cervix is unfavorable according to the score, the presence of effective contractions might indicate the patient is entering active labor spontaneously, possibly negating the need for induction agents.

How to Approach the Question

Identify the core concept: The question asks for a component that is NOT part of the Bishop's score.
Recognize the negative framing ('NOT'). This means three options are correct components, and one is the outlier.
Recall the purpose of the Bishop's score: to assess cervical readiness for induction of labor.
Systematically list the five components of the score: Cervical Dilatation, Cervical Effacement, Fetal Station, Cervical Consistency, and Cervical Position.
Evaluate each option against this list. 'Effacement', 'Cervical dilatation', and 'Station of head' are all on the list.
'Contraction' relates to uterine muscle activity, not the physical state of the cervix, and is therefore the correct answer as it is not part of the score.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 24-42

Practise the full HPSSC - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.