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DEFINITION
A postnatal fetal maturational examination. It
is an Indirect method of assessing gestational age,
based upon fetal neuromuscular and physical
maturation.
Procedure
The newborn's neuromuscular examination
includes an assessment of both active and
passive muscle tone.
POSTURE
SQUARE
WINDOW
(WRIST)
ARM RECOIL
POPLITEAL
ANGLE
SCARF SIGN
HEAL TO EAR
POSTURE
With infant supine and quiet score as follows
0 = arms and legs extended
1 = flexion of hips and knees, arms extended
2 = slight or moderate flexion of hips and
knees
3 = legs flexed and abducted, arms slightly
flexed
4 = full flexion of arms and legs
SQUARE WINDOW (WRIST)
Flex hand at the wrist. Exert pressure sufficient to get as much
flexion as possible. The angle between hypothenar eminence and
anterior aspect of forearm is measured and scored. Do not rotate
wrist. Compare angle to chart. 90°, 60°, 45°, 30°, and 0°
ARM RECOIL
With infant supine, fully flex forearm for 5 second, then fully extend by
pulling the hands and release. Score as follows:
0 = Remain extended or random movements
2 = Incomplete or Partial flexion
4 = Brisk return to full flexion
POPLITEAL ANGLE
With infant supine and pelvis flat on examining surface, flex
leg on thigh and fully flex with one hand. With the other hand extend
leg and score the angle attained according to the chart.
0 = 180 degree
1 = 160 degrees
2 = 130 degrees
3 = 110 degrees
4 = 90 degrees
5 = < 90 degrees
SCARF SIGN
With infant supine,
draw infants hand across
the neck and as far across
the opposite shoulder as
possible. Assistance to
elbow is permissible by
lifting it across the body.
Score according to location
of the elbow.