Postnatal Assessment of Gestational

Before delivery, gestational age is estimated using the date of the last menstrual period or obstetric ultrasound measurements. After birth, however, physical and neurologic criteria should be used to estimate the gestational age of the infant. The new Ballard score accurately estimates gestational age within 2 weeks for infants older than 20 weeks' gestation (Ballard et al., 1991). Identifying the preterm (less than 37 weeks) and post-term (more than 42 weeks) infant is important for appropriate risk management and observation after delivery.

The assessment of gestational age should be performed within 96 hours of birth by two separate examiners to ensure objectivity (Thureen et al., 2005). Box 22-4 and Figure 22-3 describe the new Ballard score and examination.

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