Professional Documents
Culture Documents
CM. 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 0 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 90% CM. 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 0 3.60 3.50 3.40 3.30 3.20 3.10 3.00 2.90 2.80 2.70 2.60 2.50 2.40 2.30 2.20 2.10 2.00 1.90 1.80 1.70 1.60 0
Side 2
WEEK OF GESTATION
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
LENGTH______ cm
HEAD CIRCUMFERENCE______ cm
90% 75% 50% 25% 10%
90%
WEIGHT______ gm
GM. 2400 2200 2000 1800 1600 1400 1200 1000 800 600 400 0
10%
PRE-TERM
TERM
POST-TERM
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
WEEK OF GESTATION
1st Exam (X) LARGE FOR GESTATIONAL AGE (LGA) APPROPRIATE FOR GESTATIONAL AGE (AGA) SMALL FOR GESTATIONAL AGE (SGA) Age at Exam Signature of Examiner hrs M.D./R.N. hrs M.D./R.N. 2nd Exam (O)
Adapted from Lubchenco LO, Hansman C, and Boyd E: Pediatr. 1966;37:403; Battaglia FC, and Lubchenco LO: J Pediatr. 1967;71:159.
1988, 1992, 1997, 1999 Mead Johnson & Company, Evansville, Indiana 47721 U.S.A.
NEUROMUSCULAR MATURITY
-1 Posture 0 1 2 3 4 5
MATURITY RATING
>90 90 60 45 30 0
90-110
<90
180
160
140
120
100
90
<90
Scarf Sign
Heel to Ear
PHYSICAL MATURITY
Skin sticky; friable; transparent gelatinous; red; translucent smooth; pink; visible veins superficial peeling &/or rash; few veins cracking; pale areas; rare veins bald areas parchment; deep cracking; no vessels mostly bald creases over entire sole full areola; 5-10 mm bud thick cartilage; ear stiff testes pendulous; deep rugae majora cover clitoris & minora leathery; cracked; wrinkled
SCORING SECTION
1st Exam=X
Estimating Gest Age by Maturity Rating Time of Exam
Lanugo
sparse >50 mm; no crease barely perceptible lids open; pinna flat; stays folded scrotum empty; faint rugae prominent clitoris; small labia minora
abundant faint red marks flat areola; no bud sl. curved pinna; soft; slow recoil
2nd Exam=O
stippled raised areola; areola; 1-2 mm bud 3-4 mm bud well-curved pinna; soft but ready recoil formed & firm; instant recoil testes down; good rugae majora large; minora small
Eye/Ear
lids fused loosely: -1 tightly: -2 scrotum flat; smooth clitoris prominent; labia flat
testes in testes upper canal; descending; rare rugae few rugae prominent clitoris; enlarging minora majora & minora equally prominent
Age at Exam
_________Hours
_________Hours
Ballard JL, Khoury JC, Wedig K, et al. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991;119:417-423. Lubchenco L, Hansman C, Boyd E. Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pediatrics. 1966;37:403-408. Battaglia FC, Lubchenco LO. A practical classification of newborn infants by weight and gestational age. J Pediatr. 1967;71:159-163.
Signature of Examiner
______________ ______________
M.D./R.N.
______________ ______________
M.D./R.N.
Provided Courtesy of
Unified System for Gestational Age Evaluation and Classification of the Newborn
Accurate estimation of gestational age and the evaluation of the appropriateness of fetal growth are vital in the care of newborns. A unified system has been developed which enables the physician and other health care professionals to rapidly yet accurately classify all newborns and identify the high-risk neonate. The form consists of two complementary evaluations(1) gestational age in weeks based upon selected neurologic and physical characteristics; and (2) fetal growth (weight, length, and head circumference) compared to normal standards. By these evaluations, neonates can be categorized as appropriate-for-gestational age (AGA), small-for-gestational age (SGA), and large-for-gestational age (LGA). In addition, they can also be identified as pre-term (less than 37 weeks' gestation), term (37 to 42 weeks' gestation) or post-term (greater than 42 weeks' gestation). To ensure accuracy, the procedure should be followed as outlined. This record should be placed with the newborn's permanent record.
Developed by Jacob L. Kay, M.D., Seton Medical Center, Austin, Texas; in conjunction with Mead Johnson Nutritionals, Evansville, Indiana.
Provided Courtesy of
1988, 1992, 1997 Mead Johnson & Company, Evansville, IN 47721 U.S.A.