The Apgar scale is used by obstetricians to assess the functional state of a newborn. The procedure is carried out in the nursery in the first minutes after the birth of the baby. Let's consider in more detail the algorithm of estimation, we will find out: how points are calculated on the Apgar scale, and what they mean.
"Scale Apgar" - what is it?
After the mother was informed of the calculated evaluation, the question of what Apgar scale means for what is used is in the mind of the newly mum. This technique involves determining the main functional signs that characterize the state of the newborn in the first minutes of his life. The resulting score helps to assess the overall condition of the crumbs.
The Apgar scale, used at birth, reflects the correct functioning of important organs and systems. Based on the findings, doctors provide further predictions about the viability of the child, the need for resuscitation. Assessment of the state on the Apgar scale helps pediatricians to obtain information about a newborn in the first minutes after childbirth.
Apgar scale - the history of appearance
The state of a newborn on the Apgar scale was first evaluated by an American doctor anesthesiologist. Directly her name was called the method itself. The assessment scale was officially approved in the mid-20th century, at an anesthesia congress. At this event, Virginia Apgar offered to assess the state of the newborn not only on the basis of the functioning of his organs, but also taking into account the likelihood of developing neurological disorders in the delivery room. Immediately after the congress, the Apgar scale was actively used in obstetrics.
What is assessed on the Apgar scale?
Evaluation of a newborn on the Apgar scale suggests conducting a summary analysis of 5 criteria at once. Each of these indicators is estimated on a three-point scale (0-2 points). The results indicate an estimate in the range from 0 to 10. It should be noted that this criterion is, along with weight and height, important indicators that are reported to the newly mum. The first assessment on the Apgar scale is made in the first minute of life.
For better memorization of the indicators on which diagnostics are carried out, the pediatrician Josef Butterfield suggested using the name APGAR as an abbreviation:
- A - appearance - the color of the skin;
- P - pulse - number of heartbeats;
- G - grimace - reflexes;
- A - activity - muscle tone;
- R - respiration - the number of respiratory movements.
How is the condition of a newborn?
Assessment of the state of the newborn on the Apgar scale does not require the presence of special instruments and instruments. In this procedure, the baby is exposed immediately 2 marks: after birth and 5 minutes of life. In this case, the first values are indicated in the numerator, the second values in the denominator. Assessment of the state of the newborn consists of the sum of all 5 indicators:
- Skin - have a pink tinge, from pale to bright. For this give 2 points. With cyanotic pens and legs - 1 point, uniform blue shade of skin - 0.
- Heart rate - the average parameter for newborns is 130-140 beats per minute. However, in evaluating neonatologists the following criteria are used: more than 100 beats - 2 points, less than 100 beats - 1 point, absence of pulse - 0 (resuscitation is required).
- Reflexes are among the unconditioned reflexes that are present in every newborn: first breath, cry, swallowing and sucking. Their presence is estimated at 2 points, partial absence - 1, full - 0.
- Muscle tone - after birth, the baby's head is shown in the chest, the handles are bent at the elbows, the hands are clenched into a fist. The legs are bent in the hip and knee joints. Coordination of movements is far from perfect - kids wave their arms and legs, and in this case neonatologists charge 2 points. With slow coordination, 1 point is set, a weak muscle tone is estimated at 0 points.
- Respiratory movements - an average of 40-45 per minute. This frequency is normal and 2 points are charged for it. At the same time, the first cry of the baby is evaluated, which should be loud and intense. With sluggish breathing and shouting like a groan - 1 point is displayed, complete absence of breath or crying - 0.
Apgar scale - decoding
Points on Apgar allow doctors to assess the condition of a newborn, make a prediction. So, a healthy child on the Apgar scale collects in the amount of 7-10 points. At the same time, a small percentage of newborns receives the highest score. A common evaluation is 7/8 and 8/9. The second rating, set at 5 minutes after the birth of the baby, 1-2 values higher. An important role in this is played by the method of delivery. In practice, babies born by cesarean section gain a few points more than those born naturally.
What do the Apgar scores mean?
Using a method such as the Apgar scale, the decoding of points received by the infant is performed directly by the doctors. In this case, doctors for this indicator can immediately assess the condition of the child, suggest a violation. So, when estimating 5-6 at the time of birth, neonatologists indicate an easy degree of hypoxia . If the baby is gaining 3-4 points - the average degree of oxygen starvation is diagnosed, 0-2 - indicates a severe degree of violation - suffocation requiring emergency care.
Apgar scale - table
Evaluation of the child on the Apgar scale is done using a table. It lists all possible parameters and their deviations. Doctors assess the real state of the baby while watching what parameters should be normal. Experienced neonatologists can without improvised means, allowances assess the condition of the baby and put out a common score. The results are entered in the medical record.
Low Apgar scores
A low Apgar score may indicate a difference in abnormality and pathology in a newborn. Among the frequent factors provoking such a condition of the baby:
- hypoxia of the fetus during the bearing of the child and in childbirth;
- physiological immaturity - manifested by lethargy, passivity, lack of movements, conditioned reflexes. The child sleeps for a long time, takes less food.
If the baby receives a low rating on the Apgar scale in the first minute, it is important to increase this parameter by 1-2 points in 5 minutes. Such changes indicate positive dynamics. However, such a child needs constant monitoring, special attention from the medical staff. If the baby's condition worsens, resuscitation may be necessary.