Assessment of the newborn on the Apgar scale

The baby has not had time to appear and declare itself to the whole world, he already passes the first in his life attestation. The state of his vital signs is estimated according to the methodology developed in 1952, known as the Apgar scale. How does the newborn score on the Apgar scale? Who needs these figures? What do they mean? Let's find out.

points The system for assessing the condition of a newly born child in the first minutes of life was developed by an anesthesiologist, an American Virginia Apgar. Five vital criteria are considered, each of them is assigned 0, 1 or 2 points, after which they are summed up. Thus, the maximum possible number of points is 10.

Points are counted twice: in the first minute of life, after that wait about 5 minutes and again assess. Therefore, in the test results there will always be two numbers, for example, 8/8, 7/9, etc.

Neonatologist examines newly born baby
Apgar indicators are just as important as measuring the height and weight of

It is considered a good indicator of the cond

ition of children who recruited from 7 to10 points on this scale. In this case, the baby does not need any additional care and his continued stay in the maternity hospital is an ordinary course. If the score is from 4 to 6, the condition is considered satisfactory and only some additional resuscitation procedures are applied. However, in the case of a set of less than 4 points, resuscitation should be immediate, since it is a question of the life of a small person.

Which indicators are taken into account

Heart work. A tiny heart is normally beat more frequently than in adults, doing about 120-150 beats per minute. For this reason, at 100 beats per minute and more, 2 points are given. But there are situations when the pulse can be slowed down due to oxygen starvation that has arisen in the course of labor or during a stay in the womb of the mother. Then 1 point is put. If the pulse is not probed - 0 points.

Breathing. It is normal to perform 40-45 breaths per minute. Appearing in the light, the baby should scream loudly. Then in the column "breathing" mark 2 points. If breathing is difficult, slow, breaks down, and sounds released during inspiration are more like a groan - no more than 1 point. In the absence of screaming and breathing - 0 points.

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Muscle tone. The condition is assessed at 2 points, if the crumb is actively twitching legs and handles, although initially it happens spontaneously, chaotically. This behavior is explained by the fact that in the womb the child had to be in a bent position when the head is brought to the chest, the arms are bent in the elbows, the legs are in the joints, the fingers are in the cams. If the limb movements are not active enough, put 1 point, if there are practically no movements - 0 points.

Reflexes. Here, the speed of the child's reaction is assessed, the degree of manifestation of reflex actions. If all reflexes are in place: the baby cried at the first inspiration, has a sucking reflex, and also walking and crawling, - put 2 points. If not all reflexes are expressed or manifest with outside help - 1 point. In case of their actual absence - 0 points.

Color of leather covers. 2 points for the color of the skin from pale to bright pink.1 point - if cyanosis of the lower and upper extremities is observed. At the expressed full pallor or cyanosis of a skin - 0.

Below the table is presented, evidently showing, how the estimation on a scale Apgar occurs.

0 1 2
Ripple - & lt;100 & gt;100

Skin color
Expressed cyanosis or paleness Cyan( cyanotic) color of the limbs Pink, healthy color of the body, arms, legs
Reflective reaction Virtually absent Weak All reflexes in place

Muscle tone

Poorly expressed,bend Motions are active
Breathing - With intermittent, crying weak Rhythmic, first loud shout

An important indicator is also positive dynamics. That is, if in the first minute was a score of 5 points, it would be good if in the fifth minute of life it was 7, 8 or more points. Children who do not have progressive dynamics require special attention from specialists. Sometimes an assessment of the state of health is carried out and at the 10th minute of life.

It was observed that the born babies-caesarians receive an evaluation on a scale higher. This fact is explained by the fact that such children experience less stress and difficulties than those who have to squeeze through the birth canal.

Hypoxia and Apgar

The most common cause of low scores is oxygen deficiency associated with fetal development or developed directly during labor. The danger of hypoxia is that if the brain suffers from lack of oxygen, neurological diseases can develop further. Children who have signs of hypoxia are placed in an oxygen chamber.

Cuvetes for newborns
When expressed signs of hypoxia, the child is placed in a special chamber

To minimize the development of hypoxia, the expectant mother should be observed in the antenatal clinic during the entire pregnancy, listen to medical recommendations, monitor the hemoglobin content in the blood, and pass the tests on time.

Assessment of premature infants

Babies born prematurely have signs of immaturity. They are also evaluated on the Apgar scale, only three times, and observe whether there is a positive trend. Such babies are subjected to additional examinations. For example, to evaluate the adaptation of the pulmonary system, use the Silverman scale. It is also based on 5 signs, characteristic for the work of the bronchopulmonary system of the newborn.

We saw what the Apgar scale for newborns is. Its figures should not be regarded as a sign of the inferiority of the child. The purpose of this diagnosis is to assess the state of the crash as quickly as possible and to understand whether additional resuscitative measures are needed, to understand which children need more careful monitoring. Therefore, the Apgar scale is used by obstetricians and neonatologists who are directly in the delivery room.

Newborn baby