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MATURATIONAL ASSESSMENT OF GESTATIONAL AGE (New Ballard Score)

NAME_________________________________ HOSPITAL NO. _________________________ RACE _________________________________ DATE/TIME OF BIRTH ___________________ DATE/TIME OF EXAM ___________________ AGE WHEN EXAMINED _________________ APGAR SCORE: 1 MINUTE _____________ 5 MINUTES ____________ 10 MINUTES______________ NEUROMUSCULAR MATURITY
NEUROMUSCULAR MATURITY SIGN

SEX ____________________________________ BIRTH WEIGHT __________________________ LENGTH ________________________________ HEAD CIRC. _____________________________ EXAMINER _____________________________

SCORE
-1 0 1 2 3 4 5

RECORD SCORE HERE

SCORE
Neuromuscular ______ Physical _____________ Total ________________

POSTURE MATURITY RATING SQUARE WINDOW


(Wrist) SCORE WEEKS 20 22 24 26 28 30 32 34 36 38 40 42 44

>90

90

60

45

30

-10 -5

ARM RECOIL
180 140 180 110 140 90 110

<90

0 5

POPLITEAL ANGLE 180 SCARF SIGN 160 140 120 100 90 <90

10 15 20

HEEL TO EAR

25

TOTAL NEUROMUSCULAR MATURITY SCORE

30 35 40

PHYSICAL MATURITY
PHYSICAL MATURITY SIGN

SCORE
-1 sticky friable transparent none 0 1 2 3 cracking pale areas rare veins bald areas 4 parchment deep cracking no vessels mostly bald 5 leathery cracked wrinkled

RECORD SCORE HERE

45 50

SKIN

gelatinous superficial smooth pink red peeling & / or visible veins translucent rash, few veins sparse abundant thinning anterior transverse crease only

GESTATIONAL AGE
(weeks) By dates_____________ By ultrasound________ By exam_____________

LANUGO

heel-toe PLANTAR SURFACE 4050 mm: -1 < 40 mm: -2 BREAST imperceptible lids fused loosely: -1 tightly: -2

>50 mm no crease barely perceptible lids open pinna flat stays folded

faint red marks flat areola no bud sl. curved pinna; soft; slow recoil

creases ant. 2/3

creases over entire sole

stippled areola raised areola full areola 12 mm bud 34 mm bud 510 mm bud
well-curved formed & firm thick cartilage pinna; soft but instant recoil ear stiff ready recoil

EYE / EAR

GENITALS
(Male)

testes in scrotum flat, scrotum empty upper canal smooth faint rugae rare rugae clitoris prominent & labia flat prominent clitoris & small labia minora
prominent clitoris & enlarging minora

testes descending few rugae

testes down good rugae

testes pendulous deep rugae

GENITALS
(Female)

majora & majora majora large minora equally cover clitoris minora small prominent & minora

Reference Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991; 119:417423. Reprinted by permission of Dr Ballard and MosbyYear Book, Inc.

TOTAL PHYSICAL MATURITY SCORE

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