The birth of a child is a miracle. Behind a very responsible and difficult period - the nine months that you have gotten under the heart of a new person, cared for him, worried, celebrated every movement and movement.
And now the moment comes when the baby goes to the open world. At this moment, parents need to know that everything is fine with the child.
Evaluation of the newborn on the scale of apgar
Upon completion of childbirth, the doctors who host the child put it some points, for example, 7/8, 5/6 or other apgar. What do these figures mean? And how can they determine the further development of a little man?
Score from the apgar is a method for assessing the state of a newborn at the time of its appearance. It is used in medicine for over 60 years.
For the first time, the American anesthesiologist Virginia Apgar was proposed for the first time in 1952 at the XXVII Congress of Anesthesiologists.
The development of this scale was preceded by many years of work. In all hospitals, where V. Apgar worked, she watched more than 17 thousand newborns, assessing their condition, and came to the conclusion that the child behaves in the first minutes of life, is the most important factor determining the tactics of the maintenance and treatment of the baby Subsequent.
Researcher allocated the five main indicators, which first need to pay attention to:
- color of the skin,
- heart rate,
- Muscular tone,
- reflexes,
- baby's breath.
It is worth noting that initially, the scale was intended to help only medium medical personnelSo that nurses can determine who the kids urgently need medical support, and to whom the usual care procedures are enough.
What does the apgar scale mean
Oddly enough, but the scale received its name is by no means in honor of its creator.
In the 50s of the XX century, the role of a woman in medicine was ambiguous. And so much implied that the method can be called in honor of the woman, even if she invented him.
Until 1963, the apart scale was named "The system for assessing the state of newborns in the first minutes of life", while the pediatrician Joseph Butterfield did not introduce a mnemonic (facilitating filling) for English-speaking specialists, thus fixing V. Apgar Apgar in this scale:
Appearance - appearance, color of skin.
Pulse (Heart Rate) - Pulse, heart rate.
Grimace. (Response to Simulation) - Grimas arising in response to the stimulus.
Activity (Muscle Tone) - the activity of movements, muscular tone.
Respiration - respiratory movements.
In 1965, WHO (World Health Organization) scale was recognized as mandatory for all countries.
In English, sometimes APGAR is replaced with a similar interpretation HRITC - what is deciphered as How Ready Is This Child, In the literal translation - "how much is this child is"
Heart Rate. - heart rate.
Respiratory effort - Breath.
IRRITABILITY. - Reflexes and stimuli.
Tone. - Muscle tone.
Color - color of the skin.
Test newborn apgar
During the assessment on the apgar scale with the baby, no unique tests are carried out, This is just a view.
The doctor evaluates each of the criteria, exhibiting points from 0 to 2, Where
2 - this is the most good result;
1 - average, weakly pronounced criterion;
0 - Complete lack of manifestations.
Then the points are summed up and interpreted.
Points of a newborn on the scale of apgar
In a simplified form:
- amount equal to value from 7 to 10 points - from good to the excellent condition of the child, we need ordinary care without resuscitation activities;
- Amount 4 to 6 points - satisfactory condition, some resuscitation activities are required, such as suction of mucus of nasal empty, oxygen mask or warming lamp;
- Amount less than 4 points - The child needs urgent resuscitation events.
Why two digits
The presence of two digital values \u200b\u200bhas a very simple explanation. The assessment of the state of the kid is held twice - on the first and fifth minute of the newborn life. If the indicators are underestimated, then the assessment can be repeated on the 10th minute. But if the child was born prematurely, the assessment is carried out in several other time - on the first minute of life, after 10-15 minutes and two hours later.
Scale Apgar: Decryption
In fact, this scale is pretty easy to use, which allows you to maximally reduce the time spent.
Criterion "A" (appearance; appearance, color of skin)
Perhaps the most difficult in interpretation indicator.
For 2 points, the skin of the baby should be pink on the whole body, on hand, legs. This is actually quite rare. More often, the baby's leather has a blue or burgundy shade, which is why the assessment is underestimated. However, this indicator is restored rather quickly, and most often to the fifth minute corresponds to the desired 2 points.
Criterion "P" (Pulse, Heart Rate; Pulse, Heart Frequency Frequency)
For 2 points, the pulse should be more than 100 shots per minute, ideally 130-140 beats per minute, regular, rhythmic.
1 point if the pulse is less than 100 shots.
0 points, if not.
Criterion "G" (Grimace, Response to Simulation; Grimas, arising in response to the stimulus)
2 points - the child reacts to the irritant movement, coughing, sneezing, loud cry.
1 point - the child reacts poorly to the stimulus, reluctantly moves, sluggish.
0 points - the baby does not react.
Criterion "A" (Activity, Muscle Tone; Movement Activity, Muscular Tone)
2 points - the child has active movements, active movements with handles and legs.
1 point - the child has a reduced tone, weak bending of hands and legs.
0 points - there are no movements, hands, legs hang.
Criterion "P" (respiration; respiratory movements)
2 points - regular normal breathing, 40-45 respiratory movements per minute, Creek loud, clear.
1 point - irregular breathing less than 40 respiratory movements per minute, the cry is weak, similar to a moan.
0 points - Breathing is absent.
Scale Apgar: Table
| 0 points | 1 point | 2 points | |
| Coloring skin | General (generalized) Pallor or general sinusia (cyanosis) | Pink Body Color and Blue Limit Coloring (Akricyanoz) | Pink coloring of the whole body and limbs |
| Cardiac frequency in 1 minute | There are no heartbeats | <100 | >100 |
| Reflexing excitability | Absent | The reaction is poorly expressed (grimace, movement) | Reaction in the form of movement, cough, chihanye, loud cry |
| Muscular tone | Missing limbs hang | Reduced, some flexion of the limbs | Active movements are expressed |
| Breath | Absent | Irregular, cry weak, hypoventilation | Normal, Creek Loud |
Possible causes of low scores on the apgar scale
The first and most frequent reason is congenital hypoxia, that is, the lack of oxygen intake during pregnancy or childbirth.
Also the cause may be physiological immaturity of kidas caused by prematurity and other features of the body of the mother and child.
In any case, it is worth noting that score from the apgar - this is a subjective assessmentwhich plays a role at this particular point, and does not affect the further development of the child.
More important here is still the difference between these two estimates On the first and fifth minute of the child's life, in other words, the dynamics of adaptation to the external environment, especially under low indicators. The higher the second estimate and more gap between them, the faster the kid adapts to the outside world.
And certainly no estimates will be equal to the care and love of parents. This is what is truly vital for the development of your child!
Score from the apgar scale after 1 minute indicates the initial state of the newborn, indicates those children who need more attention, and the estimate for 5 minutes - speaks of efficiency. Therefore, the assessments on the apgar scale are always two, for example 8/8 points. For most newborns, after 1 min after birth, the apart scale is estimated at 7-8 points, after 5 minutes the general condition of these newborns corresponds to 8-10 points, which is prognostically favorably. If mom knows that her baby "put" 8 points, it is very upset.
The first test that newborns are held (and most with good indicators) is an assessment of the child's condition on the apgar scale. The test was proposed in 1952 by the American anesthesiologist Virginia Apgar. The result recorded in a minute after birth and fixed again after 5 minutes, reflects the general state of the newborn and is based on observations in five estimated categories. The state of children who gain the result from 7 to 10 points is considered good or excellent, and they usually require only normal care; Those who scored from 4 to 6 points are in a satisfactory condition, and they may need only some resuscitation procedures; And those whose result is less than 4, the immediate assistance is required to save their lives. At one time it was believed that children whose result 5 minutes after birth remained low, doomed in the future to have a neurological problem, but recent studies have shown that most of these children grow up normal and quite healthy.
Evaluation on apgar.
To identify hypoxia and determining its degree of newborn children, it is customary to evaluate on the apgar scale (see Table below). The assessment is carried out on the 1-5th minute of life in 5 clinical features, each of which is estimated from 0 to 2 points. The maximum amount is 10, the minimum is 0. The rating from 1 to 4 points indicates severe hypoche-cii, and 5-6 - about easy. The amount of points from 7 to 10 indicates a satisfactory condition.
It should be emphasized that the assessment on the apgar scale one-rone characterizes the state of newborn children. It states the fact of the presence or absence of hypoxia states by the time. If low scales-le apgar oriented doctors for antihamic therapy, including resuscitation assistance, then the assessment of 7-9 points does not guarantee a complete flaw-racing. A few hours after birth, there may be an inferior to drink the deterioration of the condition caused by the syndrome of breathing disorders or other pathology.
Apgar Scale Table
Assessment of the state of a newborn baby in the first minute of life
| Signs | 0 points | 1 point | 2 points |
| Pulse | Absent | Less than 100 Up / min | Over 100 Up / min |
| Breath | Absent | Slow, irregular | Good, cry |
| Muscular tone | Weak | Flexing handles and legs | Actively moving |
| Reflexes (reaction to catheter in the nose) | Absent | Grimasi | Sneezes, cough, pushes |
| Color of the skin | Shiny, pale | Normal, but shiny handles and legs | Normal throughout the body |
Evaluation of the test results on the apgar scale
This testing is usually carried out on the first fifth minute after the birth of a child, and can be repeated later if the results turned out to be low.
Points less than 3 mean a critical state of a newborn, more than 7 is considered a good condition (norm).
The apgar scale was designed for medical staff in order to determine what children need more thorough observation.
Child, received 5 pointsneeds more closely observed than a child who received from 7-10 points.
Baby 5-6 points after a minute after birth, but in five minutes I raised my indicator to 7-10 , goes to the category of children, which can not worry about.
A child who has begun life with five points on the apgar scale and remaining with the same 5 points 5 minutes after birth ( 5-5 points) It needs more thorough observation. Ideal 10 points are rare.
Control of all indicators is carried out at the first minute after birth, then on the fifth minute of life.
In some cases, especially at low indicators, the assessment on apgar is exhibited at the 10th minute of life. Children after the cesarean section more often tend to gain more points on the apgar scale, because they do not have difficulty when passing tributes.
Mom and relatives, as a rule, report two digits, for example, 8-9 or 9-9 Points on the apgar scale say that the condition of the child immediately after birth is good.
Here are examples of the interpretation of the scale of apgar
3-3 points - Critical condition of the child
5-6 points And below - below average - requires careful observation.
6-7, 7-8 Points are average - does not require careful observation
8-8 points above average.
8-9, 9-9, 9-10 Points are good
10-10 points - Perfect (does not happen!)
Scale Apgar to assess the state of health of a newborn baby
What is the apgar scale?
Newborn baby health status assessment table In the first 5-10 minutes of life since the appearance of the light is called scale apg. Everyonenewborn baby is tested with this method immediately after birth.
Scale Apgar helps obstetrics to evaluate the viability of the baby In the first minutes of life, based on the amount of points 5 important criteria: frequency of heartbeat, breathing character, muscular tone, skin of skin, reflex excitability. If the amount of points is less than the norm, thenmore careful observation is underway for newborns And, if necessary, there is emergency medical care.
This very first check of the state of the baby after the appearance of the light was proposed by Virginia Apgar (Virginia Apgar) and used to this day since 1952.
Originally anesthesiologist Apgar proposed to assess the condition of the newly born babies on the scale developed by it to identify kids in need of urgent resuscitation events. The method was so simple, efficient and versatile, which began to be used.in obstetric practice worldwide for complex reliableestimates of the state of a newborn baby in the first minutes of life after delivery.
How is the state of health of the newborn in the first minutes of life?
Despite the fact that the state of the newborn baby Immediately after birth, it is estimated quite subjectively on the basis of an obstetric inspection, the totalevaluation of the newborn On the scale of apgar allows you to take a quick medical solution,preventing a toddler In the first minutes of life.
How is the evaluation of each of the five indicators on the apgar scale? 0 points on the table means the absence of an evaluated feature, 1 score is estimated as an average of a pronounced sign, and 2 scores on the apgar scale - a distinct sign.
Table with indicators (in points) health status of a newborn on a scale of apgar
The amount of balls exhibited by each sign determines the clinical picture of the state of health of the newborn baby. The state of the infant is determined by the values \u200b\u200bof the apgar's scale immediately from the moment the appearance of the light and five minutes after birth. Usually the total number of scale points is 7-8 (medium without pronounced pathological signs).
Value values \u200b\u200bapgar
Now consider each indicator of five on the apgar scale in more detail. Every sign of health status has just born baby corresponds to the title letter in English transcription. The letters of the names of the anesthesiologist APGAR are used for a brief designation of each of the indicators.
So, what letter correspond to a specific sign of the health of the baby on the scale of apgar:
A - ACTIVITY (Muscle Tone) : Physical activity and muscular baby tone . 2 scores on the scale are exhibited if the child will vigorously wave with handles and legs and literally breaks away from the hands of an obstetrician. 1 point - movements are not active and not frequent, but 0 points are low-voltage or practically not pronounced movements.
P - PULSE (Heart Rate) : Heart Frequency Indicator just born baby. If the pulse is more than 100 shots (the norm is 120-140 beats) per minute, then the score of the apgar is set up 2 points, if the pulse is less than 100 shots per minute, then 1 point is set, if the heartbeat is missing - 0 points are displayed.
G - Grimace (Response to Stimulation): indicatorindustion at the baby of unconditional reflexes . The reaction of the baby is evaluated for irritation. Evaluation 2 score on the apgar scale is exhibited if the reaction of the child on the touch is instant, pronounced, 1 point is a weak reaction, the child does not respond to irritation.
A -APPearance (Color) : An indicator of the appearance of the baby, as well as the color of the skin. Finein the newborn Skin color - from pale pink to bright pink. If askin color in baby pink , then an estimate on a score of 2 scores is set, not strongly pronounced sinushesity - 1 point, markedly expressed sinushesia (cyanosis caused by highhemoglobin content in blood what can besign of anemia or hypoxemia) - 0 points.
R - Respiration: Crimping severity, breathing newborn baby. If the child shouted Piercely and loud immediately after delivery, then 2 points on the apgar scale are exhibited, if there is a decrease in the respiratory frequency and the cry is noticeably weak - 1 point, the complete absence of these signs is 0 points.
Thus, according to the scale of apgar, estimates for each sign and the amount of points on five signs is an estimated criterion for the state of health of the newborn Child in the first minutes of life. An obstetrician evaluates clinicalcondition of baby On the first and fifth minute of life and the overall score on the scale has a view of two digits separated by a fraction (for example - 8/8, 9/8, 7/7, 7/8, 5/6, 6/7).
How scores are exhibited for each child's health status on the apgar scale
Often a newborn with a low estimate (0-3) on the scale is required immediate resuscitation (stimulate heartbeat, breathing, etc.)
On practice low scores on the apgar scale(3 and less than 3) speak about the threatening health of the baby state, estimate 7 or more - the normal state of the baby, and the perfect state of the health of the newborn baby (10 points) immediately after birth is extremely rare in obstetric practice.
It is important to note that often the health of the baby Five minutes after birth, it improves (the baby quickly adapts to life in a new environment and becomes more active) and the totality of points on 5 indicators of the apgar scale 5 minutes higher.
If a total rating for all scales after 5 minutes, the opposite worsens, then the obstetriccontrol over the state of health of the newborn is enhanced.
In any case, the newborn with five points and less on the scale of apgar, much more close obstetric control is required than a child who received 7,8,9 or 10 points.
Nevertheless, if a newborn With a general estimate of 5 points on the first minute of life, health condition improves and after 5 minutes the state of health on the scale of the apgar is equal to 7 or more points, then the baby automatically goes into the category of children, for whose health status is not necessary too much.
Interestingly, the kids appearing with the cesarean section , show very good results on the apgar scale, because they do not pass A difficult path of birth through natural childbirth. Usually at Caesaryat health status on the scale of apgar 8/8, 8/9 or even 9/9 points after 5 minutes.
Examples of newborn health status indicators for apgar
0/2, 1/2, 2/2 points- The state of health in the first minutes of life after birth, threatening the life of a newborn baby.
2/3, 3/3 points- (critical situation). Health status The child appeared on the light (after 5 minutes), which requires in most cases resuscitation activities.
3/4, 4/4 points (bad condition) - the state of health of the newborn requiring the close attention of obstetricians, but having a tendency to improve.
4/5, 5/6, 6/6 points (below average) - baby health On a scale of apgar, also requiring careful observation in the next week after the birth of the baby.
5/7, 6/7, 7/8 points(average condition) - the baby is still sufficiently weak, but health condition Does not require careful observation by obstetric staff.
8/8 points(above average, norm) - and without problems will begin to gain weight If the mother's lactation is in order and the baby will receive a sufficient portion of breast milk every day.
8/9, 9/9, 9/10 points (very good condition) - Baby's well-being Excellent and medical personnel there is no need to intently observe the kid.
10/10 points - the perfect condition of the newborn On the scale of apgar (rarest cases!)
According to such a scale, the initial test of the health of the infant immediately after it is birth. A total of two estimates (after 1 min. After his birth and after 5 minutes). The doctor defines an estimate consisting of 2 points immediately after the child was examined. But not every parent understands the essence of such a system and its value for doctors.
There are five criteria for estimating baby health:
- Muscular tone;
- Color of the skin;
- Pulse;
- Reflex excitability;
- The character of breathing.
An assessment of the newborn on a scale of apgar gives the opportunity to doctors-neonatologists to conclude that the kid is in and analyzing whether he needs resuscitation actions, other help or his life and health can not threaten.
Evaluation of children on the apgar scale appeared in 1952. Such a system developed Virginia apgar, which was an American anesthesiologist. Now this system is used by neonatologists from around the world. There are five estimation criteria in total, each of which is given from zero to two points. It means that the final estimate is from zero to ten points, and the higher, the better.
Scale Indicators
Newborn children are most difficult to set an objective assessment about in what state their health is. If the amount of estimates on the scale is low, it will be necessary to hold a number of medical actions. Now consider more specifically, for which the scores on the apgar scale are given. If the indicator is completely excluded, the score is 0 points, if weakly expressed - 1, in the case of a bright manifestation, the following indicators are applied to assess the child's well-being:
- Breath. With this indicator, it is determined whether the child breathes and with what intensity. According to the standards, the child's breathing should be 40-45 breathing-exhalations in 1 min. If immediately after birth, the child shows a sufficiently loud and shrill cry, it gives 2 points, breathe slowly and cry quiet or generally turning into a moan - 1, if not shouting and does not breathe - 0 and urgent honey. help.
- Pulse. Doctors are calculated, with some frequency the heart is reduced for 6 seconds. After that, multiplication is produced by 10, and as a result, it turns out a pulse for 1 min. The result of the heartbeat in babies should be 120-140 beats in 1 min. If the pulse beats at a speed of at least 100 shots in 1 min., Then they put 2 points. If no more than 100 shots in 1 min. - 1 With the complete absence of heartbeat, the infant put 0 points and conduct urgent artificial ventilation of the lungs.
- Tone muscle. As soon as it was born, the newborn begins to actively wave with his hands and legs, this means that the baby gives 2 points for such a movement. If the motor activity is insignificant and inactive - 1. In the case of complete deprivation of motor activity - 0.
- Reflexes. The score from the Apgar scale is placed on the basis of the manifestation of such reflexes as a sucking, grasing, and is the most important thing whether the child shouts and whether he breathes. In the case of loud screams, breaking, sneezing, cough kid give 2 points. With a weak response to third-party irritation - 1. If the reaction is not completely - 0.
- Color of the skin. Basically, when assessing the color of the skin, attention will focus on the palms, feet, lips and oral cavity. If the color of the skin is pink, then the score on the apgar scale will be 2 points. If there is a weak blue, then 1. If the skin is pale - 0.
After receiving the results, all estimates are summed up and the result is derived. Below to simplify an understanding of the apgar's scale is a table with all the indicators and points for them.
| Evaluation parameter | Number of points | Characteristics for assessment |
| Breath | 2 | Loud cry, smooth breathing |
| 1 | Weak Creek, Intermittent Breathing | |
| 0 | Full absence of breathing | |
| Pulse | 2 | No less than 100 shots per minute |
| 1 | Less than 100 shots per minute | |
| 0 | Full absence of heartbeat | |
| Tone muscle | 2 | Active Movements |
| 1 | Weak and Inactive Movements | |
| 0 | Full absence of movements | |
| Reflexes | 2 | A good response of the body on external stimuli (baby shouts, breathes, waving his hands and legs) |
| 1 | Weak reaction | |
| 0 | The reaction is completely absent | |
| Color of the skin | 2 | Pink skin tone throughout the body |
| 1 | The presence of skin sinusiness in some places | |
| 0 | Pale, Blue Skin |
Value of points
Most often, the estimate set 5 minutes after the birth of the baby for a pair of points is higher than the one-set per 1 minute. This is due to the fact that the baby has already managed to adapt in new conditions of life.
If in the 1st minutes of life, an appgarian score equal to 7 points is an indicator of the lack of visible disorders, then for 5 minutes. This indicator is small for the transfer of the newborn his mother, because it is necessary 8 points and higher. 10 out of 10 points on the apgar scale in the first minutes from birth - a very rare indicator. But at 5 minutes 10/10, it is quite rare.
The most common indicators are 7.8 or 9. If a newborn estimate is 6/7 or 7/7, neonatologists are inspecting over the child every 5 minutes. For 20 minutes. (That is, the baby is inspected on the fifth, tenth, fifteenth and twentieth minutes), during this inspection, doctors determine the dynamics of improvements or deterioration of health. In a short time, doctors are ready to provide an emergency medical device to the infant.
Decoding indicators
To improve the understanding of the indicators, the table of estimates on the apgar scale for newborns is given.
| Indicator | Decoding indicators |
| 0/1, 1/2, 2/2 | The state of the newborn is extremely severe, threatening life |
| 2/3, 3/3 | Critical condition, after 5 minutes it is necessary to conduct a number of resuscitation actions. |
| 3/4, 4/4 | Health state is extremely difficult, constant control is necessary. |
| 4/5, 5/6, 6/6 | The state is below average, you need to control doctors 5-7 days |
| 5/7, 6/7, 7/8 | Satisfactory health condition, no pathologies |
| 8/8 | Normal condition, baby can convey mothers |
| 8/9, 9/9, 9/10 | Excellent childhood of child |
| 10/10 | Ideal health condition (extremely rare) |
The amount of estimates on the apgar scale is sufficient: for 1 min - 7-10, and for 5 minutes - 8-10. If the baby has 7 / 8-10 / 10 indicators, then reasons for excitement, you absolutely do not have, your baby feels great.
Very often, moms with dads begin to worry if their baby has 5/7-7 / 7 indicators, but it is not worth doing this, because such assessments do not declare pronounced health violations, and even more so about disability. Most often, with such indicators there are minor problems that the neonatologist immediately reports.
In terms of 5-6 points, the newborn requires constant monitoring of the state of the baby by neonatologists, as well as it is also necessary to carry out specials. Immediately after the baby with his mother was discharged from the maternity hospital, they need to go to inspected a neuropathologist.
If the child is premature, his condition is lower than that of the ended newborns. For such kids, the total indicator is equal to 6-7 points - a good result.
In cases where the condition of the child is estimated below than 5 points, hypoxium may become the consequence and further use of resuscitation actions. Such children are observed in the hospital until the state of their health reaches estimating 7 points on the apgar scale.
Naturally, the parent wants to know about the assessment of 9 or even 10 points, and the result in 5 may cause for experiences, because it is lower than the average. But even in such cases, it is not necessary to invent too much care on an empty place, and most importantly take care of your strength and nerves, because for the upbringing of the baby they will be very needed.
This is a system of rapid assessment of the state of a newborn to clarify the need for emergency medical care. The scale was proposed by the American anesthesiologist Virginia Apgar in 1952
For more convenient memorization of Virginia's indicators, apgar has developed a system where every letter of the APGAR surname defined:
- A (Appearance) - skin color;
- P (PULS) - Pulse;
- G (Grimace) - Grimaces;
- A (Activity) - movement activity, muscle tone;
- R (Respiration) - respiratory movements, reflex excitability.
How do score calculate?
The scores on the apart scale give a quantitative assessment and summarize the reaction of a newborn baby to the ectopic medium and resuscitation (the restoration of abruptly disturbed or lost vital functions of the body - measures aimed at restoring heart contractions and respiration). Each of the five features is assigned to 0, or 1, or 2. Then five values \u200b\u200bare summed up, and the result is an assessment on the apgar scale.
The scores on the apart scale should be determined on the 1st and 5th minute after birth. If the amount at the 5th minute less than 7, additional measurements should be carried out every 5 minutes over the next 20 minutes.
What do they consider the norm?
Most newborn condition after 1 minute after birth along the apgar scale is estimated at 7-8 points, and after 5 minutes, the assessment of a healthy baby reaches 8-10 points. Only 15% of the newborn, the overall state in the first minute of life is estimated at 10 points. The state of children who are gaining from 7 to 10 points is considered good or excellent, they only need usual care. Score from the apgar scale at a birth of 0-3 points (pulse less than 100 ° C. / min., Slowing, no breathing or change, skin pale, muscular atony) corresponds to heavy asphyxia (absence of oxygen). An estimate after 1 minute after birth in 4-6 points (unspecified breathing, the heart rate is 100 ° C. / min. And more, reduced muscle tone, a weak answer to irritation) corresponds to the average degree of asphyxia. Such a child may require only some resuscitation procedures. Estimation 5 minutes after birth 6 points and below is an indication for intensive therapy or continuation of resuscitation activities.
Hope for a favorable forecast with a low estimate on the apgar scale allows the positive dynamics of the state of the baby, that is, if by the 5th minute, the kid confidently adds 1-2 points. The kids who have a low assessment have increased the likelihood that in the future it will need observation, and perhaps - and the treatment of a neurologist. However, recent indicators indicate that most of these children grow up normal and quite healthy.
Low score on the apgar scale is usually associated with the fact that the child is experiencing a deficiency of oxygen, that is, it is in a state of hypoxia, and this can be both a state of chronic hypoxia, which formed during and as well as the condition of acute hypoxia - oxygen starvation, arising during childbirth . The causes of chronic hypoxia, as a rule, is various pathology of pregnancy and possibly malformations, and the causes of acute hypoxia are various complications of childbirth. In the premature babies, the score on the apart scale is usually lower than that of the docking.
The pediatrician assesses the child's condition after birth. Usually a professional needs to be 40-60 seconds for this, for this in its arsenal there is a lot of elementary, but informative techniques. There is a clear algorithm that the doctor adheres to, finding certain results. Breathing, heartbeat and skin color are leading indicators.
| Criteria for assessment on a scale of apgar | 0 points | 1 point | 2 points |
| Coloring skin | Pallor or cyanosis (blue color) | Pink Body Color and Blue Limit Coloring (Akricyanoz) | Pink coloring of the whole body and limbs |
| Frequency of heartbeat per minute | Absent | >100 | |
| Reflex excitability (toddler reaction to the introduction of a nasal catheter) | Does not react | The reaction is poorly expressed (grimace, movement) | Reaction in the form of movement, cough, chihanye, loud cry |
| Muscular tone | Missing limbs hang | Reduced, some flexion of the limbs | Active movements are expressed |
| Breath | Absent | Irregular, cry weak | Normal, Creek Loud |
Respiratory assessment
- no breath - Stop artificial ventilation of the lungs (IVL). To do this, in the conditions of the maternity block, the so-called "Bag of Ambo" is used: the mask is applied to the nose and mouth mouth, through which the air is injected into the lungs with a rubber bag. If necessary, the child is transferred to the resuscitation unit, they are connected to the apparatus of artificial respiration;
- independent, but inadequate breathing (convulsive or irregular, superficial) - begin artificial ventilation of the lungs;
- independent regular - Assess the frequency of heart abbreviations.
Cardiac frequency assessment
- Determine the heart rate for 6 seconds using one of three methods;
- listening;
- palpation of the top shock (the doctor proves the chest infant for the definition of heartbeats);
- palpation (tackling) pulse on sleepy, femoral or umbilical arteries (for umbilical pulsation).
- Multipling the value of heart rate (heart rate) for 6 seconds by 10, the heart rate is obtained per minute.
- Possible estimates and further actions;
- CSS less than 100 shots in 1 minute - mask artificial ventilation of the lungs with 100% oxygen prior to the restoration of normal heart rate.
- CSS more than 100 shots in 1 minute - evaluate the color of the skin.
Skin Color Rating
Possible estimates and further actions:
- completely pink or pink with cyanosis (blue tint) of brushes and stops are observed for the state of the baby. If everything is fine - the child is applied to the chest;
- blue skin and visible mucousse - carry out inhalation with 100% oxygen through the facial mask before the disappearance of the blueness,
Sometimes low points obtained by the Kid on the apgar scale cause unjustified concern for the future of the child. Please do not forget that the apgar scale is not an assessment of the development and condition of the child as a whole and, moreover, not an assessment of its intellectual potentials, its main purpose is only determining the state of the baby immediately and find out the need for emergency medical care.
Discussion
we had 8/9)
03/05/2019 00:26:17, Maria9999And maybe mommies are better and not to know "these numbers". They are needed for a doctor. After all, indeed, this is the assessment of the state of the baby immediately after delivery. Mommy and so in the "shock" from Muk, and here also these points. The main thing for us is what ahead. I say that because we in 42 weeks for 1 minute it was 1-4, on the 5th - 7-8. After the hospital, a wonderful child !!! Surprisingly all the neurologists reading our statement! God forbid us and all health !!!
02/09/2009 15:32:32, MarinaVery informative article. All the time I hear this word and numbers and only now I understand what it means. But I have two children.
I have only one digit in my map ... I wonder why?
Comment Article "Estimates - from birth. What is the apgar scale?"
Scale Apgar - Assessment of the state of the child for the first minutes of life, like a scale of apgar \u003d 10. The assessment is made immediately after delivery and after some time a period of time (whether 5 and the scale of apgar is a special system for assessing the state of a newborn in the first minutes after ...
Scale Apgar - Assessment of the child's condition for the first minutes of life, such as APGAR Familia, who first began to assess the viability of a child according to a scale of apgar - this is a special system for assessing a newborn state in the first minutes after ...
Now the medical certificate of birth is issued directly by the fact of the birth of the baby, and the childbirth that occurred on what the apgar scale is considered premature? This is a system of rapid evaluation of a newborn condition for a child from birth to the year.
Scale Apgar - Assessment of the child's condition for the first minutes of life, such as resuscitation or other procedures is needed, for further development APGAR scale is a special system for assessing the state of the newborn in the first minutes after birth - in the color of the skin, shout, frequency ...
First exam: Score on the apgar scale. Back in 1952, a well-known anesthesiologist, American Virginia Apgar developed a special Each of the appegar test letters corresponds to a certain function of the body. Estimates - from birth. What is the apgar scale?
A scales of apgar - this is a special system for assessing the state of a newborn in the first minutes after birth - in color of the skin, cry, heart rate, general condition. The results obtained by the baby at birth along the apgar scale look approximately as follows.
Estimates - from birth. What is the apgar scale? The condition of children who are gaining from 7 to 10 points is considered signs of 0-1-2 ball systems: the state of heartbeat, breathing, skin cover, muscle tone, reflex excitability. Ketchup.
APGAR scale is a special system for assessing a newborn state in the first minutes after ... Newborn and scores on the apgar scale: the most important numbers. Each of the APGAR test letters corresponds to a certain function of the body.
Estimates - from birth. What is the apgar scale? Question on the scale of apgar. We do not have ZPI, but 4-6 apgar have been delivered at birth. Andrei, I do not know if there is a connection with epi, but statistics for cramps (febrile) says that there is a connection with hypoxy (asphycia) and very ...
First exam: Score on the apgar scale. Estimates on the apgar scale along with growth and weight - the first and most significant in your crumbs. During the first year of life, the kid doctors will ask mom, with which assessment on the scale of apgar, he was born.
Scale on apgar \u003d 10. The assessment is made immediately after delivery and after some interval did anyone asked Russian doctors why they underestimate the scores on the apart scale? My calculation points on the apgar scale. The newborn baby is inspecting and assigned 0 ...
scale apgar. Medical issues. A child from birth to one year. What is the apgar scale? Most newborn conditions after 1 minute after birth along the apgar scale is estimated at 7-8 points, and after 5 minutes, the assessment of a healthy baby reaches 8-10 points.
Scale apgar. Medical issues. A child from birth to one year. Care and child education up to year: nutrition, diseases, development. Abroad - apgar scale is no more than an assessment of the state of the baby immediately after delivery to determine whether emergency help needs a child.
Testing on a scale of apgar is a system of rapid assessment of the state of a newborn and determining the need for resuscitation activities. For each point, the crumbs are estimated from 0 to 2. Then the results are summed up, and a total rating from 0 to 10 ...
Counting points on the apgar scale. The newborn baby is inspected and assigned 0, 1 or 2 points each of the signs. When birth, an assessment on the apgar scale at birth in 0-3 points (pulse less than 100 ° C. / min., slow down, no breathing or change it ...
A scales of apgar - this is a special system for assessing the state of a newborn in the first minutes after birth - in color of the skin, cry, heart rate, general condition. Maximum score - 10, but this is practically no happening. 8 - very good result.
Counting points on the apgar scale. The newborn baby is inspected and assigned 0, 1 or 2 points each of the signs. Therefore, apgar estimates are always two, for example, 8/9 points. Very rarely babies are gaining 10 points in the first minute of life.
Scale apgar. . Children's medicine. Child health, illness and treatment, clinic, hospital, doctor, vaccinations. Scale apgar. Ichast of heartbeat: the pulse is missing --- 0 slowdown (less than 100 per 1 min) 1 more than 100 estimates - from birth. What is the apgar scale?
