Dubowitz SCORE UNTUK PENILAIAN BAYI BERAT LAHIR RENDAH DAN BAYI PREMATUR

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: 12

Neurologic Signs

0

1

2

3

4

5

posture

wrists, arms, hips and legs straight

wrists bent and legs slightly bent

elbows, hips and legs bent but do not reach 90°

elbows, hips and legs bent to 90°

elbows & legs drawn close to body

NA

square window (wrist)

90°

60°

45°

30°

NA

ankle dorsiflexion

90°

75°

45°

20°

NA

arm recoil

180°

90-180°

< 90°

NA

NA

NA

leg recoil

180°

90-180°

< 90°

NA

NA

NA

popliteal angle

180°

160°

130°

110°

90°

< 90°

heel to ear

leg straight, toes reach ear

leg straight, toes reach chin

knee slightly bent, heel reaches 140° from prone

knee bent, heel reaches 120° from prone

knee bent to 90°, heel reaches 90° from prone

NA

scarf sign

elbow to opposite axillary line

elbow to opposite midclavicular line

elbow to midline

elbow to axillary line

NA

NA

head lag

head lags without for-ward move-ment, at 90° to body axis

head slightly forward but does not reach body axis

head in line with body axis

head bent forward beyond body axis

NA

NA

ventral suspension

heads droops down and back greatly arched, arms & legs straight

heads slightly raised and back less curved

head raised but not to body axis, back slightly curved

head in line with body axis, back straight

head raised above body axis, back straight

NA

 

External Signs

0

1

2

3

4

edema

obvious edema of hands and feet, pitting over tibia

no obvious edema of hands & feet, pitting over tibia

no edema

NA

NA

skin texture

very thin, gelatinous

thin and smooth

smooth, medium thick-ness; rash or superficial peeling

slight thick-ening, super-ficial crack-ing & peeling, especially of hands & feet

thick & parchment-like, superficial or deep cracking

skin color

dark red

uniformly pink

pale pink; variable over body

pale; only pink over ears, lips, palms or soles

NA

skin opacity

numerous veins & venules seen, especially over abdomen

veins & tributaries seen

a few large vessels seen over the abdomen

a few large vessels seen indistinctly over the abdomen

no blood vessels seen

lanugo

none

abundant; long & thick over whole back

hair thinning, especially over lower back

small amount of lanugo & bald areas

at least half of back devoid of lanugo

plantar creases

no skin creases

faint red marks over anterior half of sole

definite red marks over > anterior 1/3; indentations over < anterior 1/3

indentations over more than anterior 1/3

definite deep indentations over more than anterior 1/3

nipple formation

nipple barely visible, no areola

nipple well-defined, are-ola smooth & flat, diameter < 0.75 cm

areola stippled, edge not raised, diameter < 0.75 cm

areola stippled, edge raised, diameter > 0.75 cm

NA

breast size

no breast tissue palpable

breast tissue on one or both sides, < 0.5 cm diameter

breast tissue on both sides, 1 or both 0.5 – 1.0 cm

breast tissue both sides, one or both > 1.0 cm

NA

ear form

pinna flat and shapeless, little or no incurving of edge

incurving of part of edge of pinna

partial incurving whole of upper pinna

well-defined incurving, whole of upper pinna

NA

ear firmness

pinna soft, easily folded, no recoil

pinna soft, easily folded, slow recoil

cartilage to edge of pinna, but soft in places, ready recoil

pinna firm, cartilage to edge, instant recoil

NA

genitals, female

labia majora widely separated, labia minora protruding

labia majora almost cover labia minora

labia majora completely cover labia minora

NA

NA

genitals, male

neither testis in scrotum

at least one testis high in scrotum

at least one testis right down

NA

NA

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.

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Clinical and Editor in Chief :

DR WIDODO JUDARWANTO

email : judarwanto@gmail.com

 

 

 

 

 

 

 

Copyright © 2009, Clinic For Children Information Education Network. All rights reserved.

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