BALLARD SCOREBallard score merupakan suatu versi sistem Dubowitz. Pada prosedur ini penggunaan kriteria neurologis tidak tergantung pada keadaan bayi yang tenang dan beristirahat, sehingga lebih dapat diandalkan selama beberapa jam pertama kehidupan. Penilaian menurut Ballard adalah dengan menggabungkan hasil penilaian maturitas neuromuskuler dan maturitas fisik. Kriteria pemeriksaan maturitas neuromuskuler diberi skor, demikian pula kriteria pemeriksaan maturitas fisik. Jumlah skor pemeriksaan maturitas neuromuskuler dan maturitas fisik digabungkan, kemudian dengan menggunakan tabel nilai kematangan dicari masa gestasinya.

Overview :The score proposed by Dubowitz et al assesses an infant for the apparent gestational age by considering both neurologic and external signs of development.Components: neurological signs: 10 external signs: 12Neurologic Signs012345

posturewrists, arms, hips and legs straightwrists bent and legs slightly bentelbows, hips and legs bent but do not reach 90elbows, hips and legs bent to 90elbows & legs drawn close to bodyNA

square window (wrist)906045300NA

ankle dorsiflexion907545200NA

arm recoil18090-180< 90NANANA

leg recoil18090-180< 90NANANA

popliteal angle18016013011090< 90

heel to earleg straight, toes reach earleg straight, toes reach chinknee slightly bent, heel reaches 140 from proneknee bent, heel reaches 120 from proneknee bent to 90, heel reaches 90 from proneNA

scarf signelbow to opposite axillary lineelbow to opposite midclavicular lineelbow to midlineelbow to axillary lineNANA

head laghead lags without for-ward move-ment, at 90 to body axishead slightly forward but does not reach body axishead in line with body axishead bent forward beyond body axisNANA

ventral suspensionheads droops down and back greatly arched, arms & legs straightheads slightly raised and back less curvedhead raised but not to body axis, back slightly curvedhead in line with body axis, back straighthead raised above body axis, back straightNA

External Signs01234

edemaobvious edema of hands and feet, pitting over tibiano obvious edema of hands & feet, pitting over tibiano edemaNANA

skin texturevery thin, gelatinousthin and smoothsmooth, medium thick-ness; rash or superficial peelingslight thick-ening, super-ficial crack-ing & peeling, especially of hands & feetthick & parchment-like, superficial or deep cracking

skin colordark reduniformly pinkpale pink; variable over bodypale; only pink over ears, lips, palms or solesNA

skin opacitynumerous veins & venules seen, especially over abdomenveins & tributaries seena few large vessels seen over the abdomena few large vessels seen indistinctly over the abdomenno blood vessels seen

lanugononeabundant; long & thick over whole backhair thinning, especially over lower backsmall amount of lanugo & bald areasat least half of back devoid of lanugo

plantar creasesno skin creasesfaint red marks over anterior half of soledefinite red marks over > anterior 1/3; indentations over < anterior 1/3indentations over more than anterior 1/3definite deep indentations over more than anterior 1/3

nipple formationnipple barely visible, no areolanipple well-defined, are-ola smooth & flat, diameter < 0.75 cmareola stippled, edge not raised, diameter < 0.75 cmareola stippled, edge raised, diameter > 0.75 cmNA

breast sizeno breast tissue palpablebreast tissue on one or both sides, < 0.5 cm diameterbreast tissue on both sides, 1 or both 0.5 1.0 cmbreast tissue both sides, one or both > 1.0 cmNA

ear formpinna flat and shapeless, little or no incurving of edgeincurving of part of edge of pinnapartial incurving whole of upper pinnawell-defined incurving, whole of upper pinnaNA

ear firmnesspinna soft, easily folded, no recoilpinna soft, easily folded, slow recoilcartilage to edge of pinna, but soft in places, ready recoilpinna firm, cartilage to edge, instant recoilNA

genitals, femalelabia majora widely separated, labia minora protrudinglabia majora almost cover labia minoralabia majora completely cover labia minoraNANA

genitals, maleneither testis in scrotumat least one testis high in scrotumat least one testis right downNANA

Dubowitz score == SUM (points for each parameter)Interpretation: minimum score: 0 maximum score: 72 (neurological sign 35, external sign 37)estimated gestational age == (0.2642 * (total score)) + 24.595

References:

Dubowitz LMS, Dubowitz V, Goldberg C. Clinical assessment of gestational age in the newborn infant. J Pediatr. 1970; 77: 1-10.