Ballard Maturational Assessment of Gestational Age

NEUROMUSCULAR MATURITY  
SCORE RECORD
NEUROMUSCULAR
SCORE
MATURITY SIGN -1 0 1 2 3 4 5 HERE

POSTURE      

SQUARE WINDOW
   
(Wrist)

ARM RECOIL      

POPLITEAL ANGLE  

SCARF SIGN    

HEEL TO EAR    

TOTAL NEUROMUSCULAR
 
MATURITY SCORE
PHYSICAL MATURITY
RECORD
PHYSICAL SCORE SCORE
MATURITY SIGN HERE
-1 0 1 2 3 4 5
superficial
gelatinous, cracking, pale parchment, leathery,
sticky, friable, smooth pink, peeling &/or
SKIN red, areas, rare deep cracking, cracked,  
transparent visible veins rash, few
translucent veins no vessels wrinkled
veins
LANUGO none sparse abundant thinning bald areas mostly bald    
heel-toe anterior
PLANTAR >50 mm faint red creases ant. creases over
40-50 mm: -1 transverse    
SURFACE no crease marks 2/3 entire sole
<40 mm: -2 crease only
barely flat areola stippled areola raised areola full areola
BREAST imperceptable    
perceptable no bud 1-2 mm bud 3-4 mm bud 5-10 mm bud
lids fused lids open sl. curved well-curved formed &
thick cartilage
EYE / EAR loosely: -1 pinna flat pinna; soft; pinna; soft but firm    
ear stiff
tightly: -2 stays folded slow recoil ready recoil instant recoil
scrotum testes in upper testes testes
GENITALS scrotum flat, testes down,
empty, canal, descending, pendulous,    
(Male) smooth good rugae
faint rugae rare rugae few rugae deep rugae
prominent prominent majora &
clitoris majora cover
GENITALS clitoris & clitoris & minora majora large,
prominent & clitoris &    
(Female) small labia enlarging equally minora small
labia flat minora
minora minora prominent
TOTAL PHYSICAL
 
MATURITY SCORE

References :
Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature
 
SCORE
Neuromuscular:  
Physical:  
Total:  
MATURITY RATING

score weeks
-10 20
-5 22
0 24
5 26
10 28
15 30
20 32
25 34
30 36
35 38
40 40
45 42
50 44