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    Dubowitz Ballard Score CHeRP 2007

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    istinengtiyas
    This document provides instructions for using the Dubowitz/Ballard scoring method to assess gestational age in newborn babies weighing less than 2000g. It describes how to score six neuromuscular features and six physical features of external maturity. The individual scores are added to give a total score, which is then used to estimate gestational age in weeks according to a provided conversion table. The process also involves plotting the baby's weight and length on a growth chart to determine if they are appropriate, underweight or overweight for their gestational age.

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    Dubowitz Ballard Score CHeRP 2007

    Uploaded by

    istinengtiyas
    181 views1 page
    This document provides instructions for using the Dubowitz/Ballard scoring method to assess gestational age in newborn babies weighing less than 2000g. It describes how to score six neuromuscular features and six physical features of external maturity. The individual scores are added to give a total score, which is then used to estimate gestational age in weeks according to a provided conversion table. The process also involves plotting the baby's weight and length on a growth chart to determine if they are appropriate, underweight or overweight for their gestational age.

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    DUBOWITZ/BALLARD SCORING FOR GESTATIONAL AGE

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    This document provides instructions for using the Dubowitz/Ballard scoring method to assess gestational age in newborn babies weighing less than 2000g. It describes how to score six neuromuscular features and six physical features of external maturity. The individual scores are added to give a total score, which is then used to estimate gestational age in weeks according to a provided conversion table. The process also involves plotting the baby's weight and length on a growth chart to determine if they are appropriate, underweight or overweight for their gestational age.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    181 views1 page

    Dubowitz Ballard Score CHeRP 2007

    Uploaded by

    istinengtiyas
    This document provides instructions for using the Dubowitz/Ballard scoring method to assess gestational age in newborn babies weighing less than 2000g. It describes how to score six neuromuscular features and six physical features of external maturity. The individual scores are added to give a total score, which is then used to estimate gestational age in weeks according to a provided conversion table. The process also involves plotting the baby's weight and length on a growth chart to determine if they are appropriate, underweight or overweight for their gestational age.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    N e o n a t a l

    Department of Paediatrics

    PROVINCE OF KWAZULU-NATAL
    HEALTH SERVICES

    G u i d e l i n e s

    ISIFUNDAZWE SAKWAZULU
    EMPILO

    P ie t er m ar i t zb u r g
    Me tr op o l it a n
    Hos p it a ls Com p lex

    KWAZULU-NATAL PROVINSIE
    GESONDHEIDSDIENSTE

    DUBOWITZ/BALLARD SCORING

    FOR

    GESTATIONAL AGE

    Instructions for doing it properly


    Obtain a gestational age score on all babies weighing less than 2000g, within 24 hours of delivery. This
    assists in making appropriate care plans, especially at the limits of viability. It is preferable to wait
    until baby is settled before scoring, but sometimes an early score (soon after delivery) is essential

    Score for both neuromuscular and external/physical features. Add each to give a final score, and then give a maturity
    rating (in weeks) by referring to the conversion table. Complete the process by plotting babys weight and length on the
    neonatal growth chart, and documenting whether baby is appropriate, under- or overweight for gestational age.

    Neuromuscular Maturity
    Assess all six features with baby lying supine (spine on bed), and awake but not crying. Refer to the chart while
    assessing. Accuracy is improved if you assess both sides of the body, and use the average score.
    1) Posture:
    Observe the posture. Handling the infant may improve the
    assessment.
    2) Square Window:
    Flex the hand at the wrist. Exert pressure sufficient to get as much
    flexion as possible. The angle between the hypothenar eminence
    and the anterior aspect of the forearm is measured and scored.
    3) Arm Recoil:
    Fully flex the forearms with the hands at the shoulders for 5
    seconds, then fully extend by pulling the hands. Release as soon
    as the elbows are fully extended, and observe the recoil (degree of
    flexion at the elbows). Random movements do not count.
    4) Popliteal Angle:
    With the pelvis flat on the examining surface, use one hand to bring
    the knee onto the abdomen. With the other hand, gently push
    behind the ankle to bring the foot towards the face.
    5) Scarf Sign:
    Take the infant's hand and draw it across the neck and as far across the opposite shoulder as possible, like a scarf.
    Assistance to the elbow is permissible by lifting it across the body. Score according to the location of the elbow.
    6) Heel to Ear:
    Hold the infant's foot with one hand and move it as near to the head as possible without forcing it. The knee may slide
    down the side of the abdomen. Keep the pelvis flat on the examining surface.

    Physical Maturity
    The six features examined are self explanatory in the table below.
    Sign

    -1

    Skin

    Sticky, friable,
    transparent

    Gelatinous, red,
    translucent

    Smooth, pink, visible


    veins

    Superficial peeling
    and/or rash, few veins

    Cracking, pale
    areas, rare veins

    Parchment, deep
    cracking, no vessels

    Leathery, cracked,
    wrinkled

    None

    Sparse

    Lanugo
    Plantar
    Creases

    Heel-toe 40-50 mm = -1, Heel-toe >50 mm, no


    creases

    Abundant

    Thinning

    Bald areas

    Mostly bald

    Faint red marks

    Anterior transverse
    crease only

    Creases over
    anterior 2/3

    Creases over entire


    sole

    Breast

    Imperceptible

    Barely perceptible

    Flat areola, no bud

    Stippled areola, 1-2 mm


    bud

    Raised areola, 3-4


    mm bud

    Full areola, 5-10 mm


    bud

    Eye & Ear

    Lids fused, loosely = -1,


    tightly = -2

    Lids open, pinna flat,


    stays folded

    Slightly curved pinna,


    soft with slow recoil

    Well-curved pinna, soft


    but ready recoil

    Formed and firm,


    with instant recoil

    Thick cartilage, ear stiff

    Genitals, male

    Scrotum flat, smooth

    Scrotum empty, faint


    rugae

    Testes in upper
    cannal, rare rugae

    Testes descending, few


    rugae

    Testes down, good


    rugae

    Testes pendulous,
    deep rugae

    Genitals,
    female

    Clitoris prominent, labia


    flat

    Prominent clitoris,
    small labia minora

    Prominent clitoris,
    enlarging minora

    Majora and minora


    equally prominent

    Majora large,
    minora small

    Majora cover clitoris


    and minora

    Maturity Rating
    Add up the individual Neuromuscular and Physical Maturity scores for the twelve categories, then obtain the estimated
    gestational age from the table below.
    Total Score
    Gestational Age (in 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

    Use a scoring sheet with weight chart (Form Paed/02). Write the score in the designated space on page
    1 of the Infant Care Record (Form Paed/01).

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