Extremely Low Birth Weight (ELBW -
NCC)14
Ballard Exam - ANSWERS-Physical: skin, lanugo, plantar surface, breast, eyes, ears, genitalia
Vernix: <34 weeks thick, 34-38 absorbing, 38-40 only in folds
Plantar surface: <28 week no creases
breast: < 28 week imperceptible nipples, 32-37 well defined nipples, term: nipple raised areola
eyes: < 26 weeks fused
ears: <34 immature pinna, cartilage not present
genitalia: male - <28 wk empty and flat scrotum, term rugae
female - preemie prominent clitoris, term more prominent labia majorum
umbilical vein - ANSWERS-delivers oxygenated blood from the placenta to the fetus
ductus venosus - ANSWERS-connects the umbilical vein to the inferior vena cava, bypassing the
liver
foramen ovale - ANSWERS-connects the two atria in the fetal heart
ductus arteriosus - ANSWERS-a blood vessel in a fetus that bypasses pulmonary circulation by
connecting the pulmonary artery directly to the ascending aorta
umbilical artery - ANSWERS-carries deoxygenated blood from fetus to placenta
SGA (small for gestational age) - ANSWERS-Having a birth weight that is below the 10th
percentile on intrauterine growth charts
, AGA (appropriate for gestational age) - ANSWERS-within the 90th and the 10th percentile for
weight
LGA (large for gestational age) - ANSWERS-Defined as a newborn who's weight is above the 90th
percentile
IUGR (intrauterine growth restriction) - ANSWERS-deviation in expected fetal growth pattern
caused by multiple adverse conditions:
birthweight <3% or 3 of the following:
- birthweight <10%
- head circumference <10%
- length <10%
- prenatal diagnosis of growth restriction
- history of conditions associated with fetal growth restriction (maternal HTN, PreE, congenital
infection)
Neuromuscular assessment - ANSWERS-1. posture/tone
- <30wk hypotonia
- 30-38 varying degrees of flexion
- 38+ hypertonic
2. square window wrist
- more immature = less able to flex wrist
3. arm recoil - extend arm and then release
- <24wk no recoil
- term complete recoil
4. popliteal angle - angle decreases with advancing gestational age
NCC)14
Ballard Exam - ANSWERS-Physical: skin, lanugo, plantar surface, breast, eyes, ears, genitalia
Vernix: <34 weeks thick, 34-38 absorbing, 38-40 only in folds
Plantar surface: <28 week no creases
breast: < 28 week imperceptible nipples, 32-37 well defined nipples, term: nipple raised areola
eyes: < 26 weeks fused
ears: <34 immature pinna, cartilage not present
genitalia: male - <28 wk empty and flat scrotum, term rugae
female - preemie prominent clitoris, term more prominent labia majorum
umbilical vein - ANSWERS-delivers oxygenated blood from the placenta to the fetus
ductus venosus - ANSWERS-connects the umbilical vein to the inferior vena cava, bypassing the
liver
foramen ovale - ANSWERS-connects the two atria in the fetal heart
ductus arteriosus - ANSWERS-a blood vessel in a fetus that bypasses pulmonary circulation by
connecting the pulmonary artery directly to the ascending aorta
umbilical artery - ANSWERS-carries deoxygenated blood from fetus to placenta
SGA (small for gestational age) - ANSWERS-Having a birth weight that is below the 10th
percentile on intrauterine growth charts
, AGA (appropriate for gestational age) - ANSWERS-within the 90th and the 10th percentile for
weight
LGA (large for gestational age) - ANSWERS-Defined as a newborn who's weight is above the 90th
percentile
IUGR (intrauterine growth restriction) - ANSWERS-deviation in expected fetal growth pattern
caused by multiple adverse conditions:
birthweight <3% or 3 of the following:
- birthweight <10%
- head circumference <10%
- length <10%
- prenatal diagnosis of growth restriction
- history of conditions associated with fetal growth restriction (maternal HTN, PreE, congenital
infection)
Neuromuscular assessment - ANSWERS-1. posture/tone
- <30wk hypotonia
- 30-38 varying degrees of flexion
- 38+ hypertonic
2. square window wrist
- more immature = less able to flex wrist
3. arm recoil - extend arm and then release
- <24wk no recoil
- term complete recoil
4. popliteal angle - angle decreases with advancing gestational age
