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Reliability of the Bishop score before labour induction at term
Ellen F Faltin-Traub1, Michel Boulvain, Daniel L Faltin
1Department of Obstetrics and Gynaecology, University Hospital Geneva, Geneva 14 1211, Switzerland. daniel-faltin@hcuge.ch
Objective:
To evaluate the agreement within three pairs of observers regarding the Bishop score and an informal global evaluation of the cervix (favourable/unfavourable).
Study Design:
We conducted a reliability study of the Bishop score. Three pairs of examiners (A-B, A-C and D-E) performed independently a cervical examination in 156 term pregnant women admitted for labour induction. We calculated the proportion of agreement and the Kappa coefficient.
Results:
Perfect agreement between two observers for the Bishop score was found in 44 women (28%). Accepting a difference of one point between the observers, agreement increased to 66%. Weighted Kappa coefficients for the Bishop score were 69, 54 and 35% for each pair of observers. Kappa coefficients for the informal evaluation of the cervix were 64, 45 and 46, respectively.
Conclusion:
Agreement between two observers evaluating the cervix is fair to substantial. An informal evaluation of the cervix is as reliable as the Bishop score.