GESTATIONAL-AGE ASSESSMENT BY NURSES IN A DEVELOPING-COUNTRY USING THE BALLARD-METHOD, EXTERNAL CRITERIA ONLY

The aim of this study was to evaluate postnatal examination of the new born by nurses in a developing country, using a modified Ballard metho d, scoring for the six external criteria only (Ballard-ext.). Applicab ility of gestational age estimates with the Ballard-ext. was assessed by calculating its agreement with gestational age derived from the las t menstrual period (LMP), fundal height and the Dubowitz method. The s mallest difference in gestational age and the most narrow limits of ag reement were found between the Ballard-ext. and the Dubowitz method. N o reliable gestational age could be obtained from LMP or fundal height . At low gestational ages, Ballard-ext. tended to give lower gestation al ages compared with the Dubowitz method. At an average gestational a ge of more than 251 days, Ballard-ext. gave higher values compared wit h Dubowitz. Both Ballard-ext. and the Dubowitz method identified 48% o f low birthweight babies as growth-retarded (gestational age greater t han or equal to 37 weeks). No significant difference in gestational ag e assessment of newborns between nurses was observed. The Ballard meth od, scoring for external criteria alone, compared favourably with the Dubowitz method. The test is simple to perform and can be reliably use d routinely by nurses.