The Ballard Score Maturational Assessment of Gestational Age in Newly Born Infants

Physical Maturity

Ballard Score Training - Performing the Assessment of Physical Maturity

1. Skin
Maturation of fetal skin involves the development of its intrinsic structures concurrent with the gradual loss of its protective coating, the vernix caseosa.
2. Lanugo
Lanugo is the fine hair covering the body of the fetus.
3. Plantar Surface
This item pertains to the major foot creases on the sole of the foot.
4. Breast
The breast bud consists of breast tissue that is stimulated to grow by maternal estrogens and fatty tissue which is dependent upon fetal nutritional status.
5. Eye/Ear
The pinna of the fetal ear changes it configuration and increases in cartilage content as maturation progresses. The examiner may also note the state of eyelid development as an additional indicator of fetal maturation.
6. Genitals-Male
The fetal testicles begin their descent from the peritoneal cavity into the scrotal sack at approximately the 30th week of gestation.
7. Genitals-Female
The fetal labia majora contain fat and their size are affected by intrauterine nutrition. In extreme prematurity, the labia are flat and the clitoris is very prominent and may resemble the male phallus.