Since certain fetal stresses may occur without the patient's of physician's knowledge, the assessment of gestational age by maturational exam is is fraught with uncertainties similar to, and probably greater than those surrounding fetal ultrasound examination.
Keeping those limitations in mind, one can more fully appreciate the usefulness of both methods of fetal age assessment.
Having said this, the neonatal maturational examination remains the most universally accepted postnatal method of assessing gestational age.
To perform the assessment, the most sophisticated of all technological developments is necessary - the clinical observer.