Maturational Assessment Of Gestational Age (New Ballard Score) Chart
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1MATURATIONAL ASSESSMENT OF GESTATIONAL AGE (New Ballard Score)
NAME_________________________________
SEX ____________________________________
HOSPITAL NO. _________________________
BIRTH WEIGHT __________________________
RACE _________________________________
LENGTH ________________________________
DATE/TIME OF BIRTH ___________________
HEAD CIRC. _____________________________
DATE/TIME OF EXAM ___________________
EXAMINER _____________________________
AGE WHEN EXAMINED _________________
APGAR SCORE: 1 MINUTE _____________ 5 MINUTES ____________ 10 MINUTES______________
NEUROMUSCULAR MATURITY
SCORE
SCORE
RECORD
NEUROMUSCULAR
Neuromuscular ______
SCORE
MATURITY SIGN
-1
0
1
2
3
4
5
HERE
Physical _____________
Total ________________
POSTURE
MATURITY RATING
SQUARE WINDOW
SCORE
WEEKS
(Wrist)
>90°
90°
60°
45°
30°
0°
-10
20
ARM RECOIL
-5
22
180°
140 –180°
110 –140°
90 –110°
<90°
0
24
POPLITEAL ANGLE
5
26
180°
160°
140°
120°
100°
90°
<90°
10
28
SCARF SIGN
15
30
20
32
HEEL TO EAR
25
34
30
36
TOTAL NEUROMUSCULAR
MATURITY SCORE
35
38
PHYSICAL MATURITY
40
40
SCORE
RECORD
PHYSICAL
45
42
SCORE
MATURITY SIGN
-1
0
1
2
3
4
5
HERE
50
44
sticky
gelatinous
superficial
cracking
parchment
leathery
smooth pink
friable
red
peeling & / or
pale areas
deep cracking
cracked
SKIN
visible veins
transparent
translucent
rash, few veins
rare veins
no vessels
wrinkled
GESTATIONAL AGE
(weeks)
LANUGO
none
sparse
abundant
thinning
bald areas
mostly bald
By dates_____________
By ultrasound________
By exam_____________
heel-toe
anterior
>50 mm
faint
creases
creases over
PLANTAR SURFACE
40–50 mm: -1
transverse
no crease
red marks
ant. 2/3
entire sole
< 40 mm: -2
crease only
barely
flat areola
stippled areola
raised areola
full areola
BREAST
imperceptible
perceptible
no bud
1–2 mm bud
3–4 mm bud
5–10 mm bud
lids fused
lids open
sl. curved
well-curved
formed & firm
thick cartilage
loosely: -1
pinna flat
pinna; soft;
EYE / EAR
pinna; soft but
instant recoil
ear stiff
tightly: -2
stays folded
slow recoil
ready recoil
testes in
testes
testes
GENITALS
scrotum flat,
scrotum empty
testes down
upper canal
descending
pendulous
(Male)
smooth
faint rugae
good rugae
rare rugae
few rugae
deep rugae
prominent
clitoris
prominent
majora &
majora
GENITALS
majora large
clitoris &
prominent
clitoris & small
minora equally
cover clitoris
(Female)
enlarging
minora small
& labia flat
labia minora
prominent
& minora
minora
Reference
TOTAL PHYSICAL
Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants.
MATURITY SCORE
J Pediatr 1991; 119:417–423. Reprinted by permission of Dr Ballard and Mosby—Year Book, Inc.
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