Ballard gestational-age assessment tool
To complete this assessment, evaluate and score the neonate’s neuromuscular and physical maturity, total the score, and then plot the sum in the maturity rating box to determine the gestational age.
Posture
With the neonate supine and quiet, score as follows:
Arms and legs extended = 0
Slight or moderate flexion of hips and knees = 1
Moderate to strong flexion of hips and knees = 2
Legs flexed and abducted, arms slightly flexed = 3
Full flexion of arms and legs = 4
Square window
Flex the hand at the wrist. Measure the angle between the base of the thumb and the forearm. Score as follows:
>90 degrees = -1
90 degrees = 0
60 degrees = 1
45 degrees = 2
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