How is Down syndrome diagnosed in the newborn?

Hall’s ten cardinal signs of Down Syndrome

Neonatal sign	%
Poor moro reflex	85
Hypotonia	80
Flat facial profile	90
Upward-slanting palpebral fissures	80
Simple, small round ears	60
Redundant loose neck skin	80
Single palmar crease	45
Hyperextensible large joints	80
Pelvis radiograph abnormal	70
Hypoplasia of fifth-finger	60

Upslant palpebral fissures Depressed nasal bridge	Low set ears Protruding tongue	Frontal bossing Flat mid face Flat occiput	Upslant palpelral fissures Protruding tongue
Transverse palmar crease both hands		Clinodactyly of 5^th fingers both hands (5^th fingers curve inward)
Clinodactyly of the 5^th finger (inwardly curved)		Wide gap between 1^st and 2^nd toe
Hypotonia

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