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The

  

 


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is a commonly used
technique of gestational age assessment. It assigns a score to various criteria the sum of all of
which is then extrapolated to the gestational age of the baby. These criteria are divided into

and  

criteria. This scoring allows for the estimation of age in the range of
26 weeks-44 weeks. The New Ballard Score is an extension of the above to include extremely
pre-term babies i.e. up to 20 weeks.

The scoring relies on the intra-uterine changes that the fetus undergoes during its maturation.
Whereas the neurological criteria depend mainly upon muscle tone the physical ones rely on
anatomical changes. The neonate (less than 28 days of age) is in a state of physiological
hypertonia. This tone increases throughout the fetal growth period meaning a more premature
baby would have lesser muscle tone.
It was developed in 1979

 
  
These are:

1.c Skin
2.c Ear/Eye
3.c Lanugo Hair
4.c Plantar Surface
5.c Breast bud
6.c Genitals

-   

  

1.c Posture
2.c Square Window
3.c Arm Recoil
4.c Popliteal Angle
5.c Scarf sign
6.c Heel to Ear

-  

Each of the above criteria are scored from 0 through 5 in the original Ballard Score. The scores
were then ranged from 5 to 50 with the corresponding gestational ages being 26 weeks and 44
weeks. An increase in the score by 5 increases the age by 2 weeks. The New Ballard Score
allows scores of -1 for the criteria hence making negative scores possible. The possible scores
then range from -10 to 50 the gestational range extending up to 20 weeks. (A simple formula to
come directly to the age from the Ballard Score is Age=(2*score+120) /5)

Often the most important tool in medicine is the skilled examiner. Over the course of gestation
babies develop a wide range of characteristics that can be measured through simple examination.
As the baby develops muscle tone distinct posture ensues as well as measurable angles of
resistance in key muscle groups.

Physical characteristics are also key in determining gestational age. The eyes transform from
being fused in very premature infants to wide open in full-term babies. The skin and hair also
give away important information in determining gestational age as well as a host of other
characteristics described in this site.


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