NEONATE: Gestational Age BALLARD/DUBOWITZ SCALE Flashcards
Why is it important to determine Gestational Age?
Gestational assessment:
Assessing a baby’s physical maturity is an important part of care. Maturity assessment is helpful in meeting a baby’s needs if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than it appears by size, and may need different care than a premature baby.
An examination called The Dubowitz/Ballard Exam for Gestational Age is often used. A baby’s gestational age often can be closely estimated using this exam. The Dubowitz/Ballard Exam evaluates a baby’s appearance, skin texture, motor function and reflexes. The physical maturity part of the exam is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery. Information often used to help estimate babies physical and neuromuscular maturity are shown below.
How is gestational age determined?
The Dubowitz/Ballard Exam evaluates a baby’s appearance, skin texture, motor function and reflexes.
The physical maturity part of the exam is done in the first two hours of birth.
The neuromuscular maturity examination is completed within 24 hours after delivery.
Dubowitz/Ballard Exam Point Scale (-1 to 5)
The physical maturity part of the exam is done in the first two hours of birth.
The neuromuscular maturity examination is completed within 24 hours after delivery.
Dubowitz/Ballard Exam: Physical Maturity (7)
Skin - ranges from sticky and red to smooth to cracking or peeling.
Lanugo (the soft downy hair on a baby’s body) is absent in immature babies then appears with maturity and then disappears again with post-maturity.
Plantar creases - these creases on the sole of the feet range from absent to covering the entire foot depending on the maturity.
Breast - the thickness and size of breast tissue and areola (the darkened nipple area) are assessed.
Eyes and ears - eyes fused or open and amount of cartilage and stiffness of the ear tissue are assessed.
Genitals, male - presence of testes and appearance of scrotum, from smooth to wrinkled.
Genitals, female - appearance and size of the clitoris and the labia.
Dubowitz/Ballard Exam: Neuromuscular Maturity
Neuromuscular maturity:
Six evaluations of the baby’s neuromuscular system are performed.
Posture - how does the baby hold his or her arms and legs.
Square window - how much the baby’s hand can be flexed toward the wrist.
Arm recoil - how much the baby’s arms “spring back” to a flexed position.
Popliteal angle - how much the baby’s knee extends.
Scarf sign - how far the elbow can be moved across the baby’s chest.
Heel to ear - how close the baby’s foot can be moved to the ear.
New Ballard Scale
totals added to give a maturity rating in weeks gestation
New Ballard Scale a score of 35 indicates?
38 weeks gestation
