2023 Author: Priscilla Miln | [email protected]. Last modified: 2023-11-26 06:25
Immediately after birth, a newborn receives its first Apgar score. It is formed on the basis of a study by specialists of important indicators of the child - breathing, skin color, heart rate, assessment of muscle tone and reflexes of the newborn. Further actions of medical workers will depend on the results of this study. And it is the assessment of the newborn on the Apgar scale that will determine what care should be taken for the child who was born, and whether he needs additional conditions. In addition, this study may indicate to specialists the likelihood of any pathology immediately after delivery.
What does the Apgar scale mean
This study was proposed by the American anesthesiologist Virginia Apgar in the middle of the last century, namely in 1952. Its original purpose was to use the newborn's vital sign assessment to help nurses determine which babies needed special care.
This study also helps to find out how difficult the process of childbirth was for the child,how he influenced him. Each of the main indicators can be affected by difficult births. For example, during delivery, a child may experience hypoxia, that is, a lack of oxygen as a result of being pulled with special forceps or having a hard time passing through the birth canal. As a result, the skin may change, which will subsequently affect the assessment of specialists on this scale.
From the foregoing, it follows that this study, in exceptionally rare cases, may indicate the possibility of the occurrence or presence of any pathology and pathological condition in a newborn child. In all other situations, an assessment of the main indicators of the baby who was born is necessary to understand how much the birth has affected the somatic condition of the child and what the child's condition is immediately after the completion of the delivery process.
It should be understood that in most cases this study is subjective. Many factors can affect the final grade, the main of which is the severity of the birth process.
A child with an average score may be in better he alth than a child with the highest score in the study.
How measurements are taken
The scale proposed by an American physician includes five indicators, the measurement of which takes place in the first and fifth minutes of a newborn's life. Each criterion is scored from 0 to 2 points. Accordingly, the higher the indicator, the better the condition of the child at the time of birth. If the result of the study is less than 7 points, specialists continue to monitor the condition of the baby at 10 and 15 minutes of life.
If, as a result of the study, the condition on the Apgar scale is assessed as low, specialists decide whether to transfer the newborn to a special department for placement in a special box and for additional medical care.
If a child has low scores at birth, a specialist from the medical institution performs resuscitation, due to which the score obtained as a result of the secondary study increases significantly.
Newborn He alth Indicators
In total, five fundamental indicators of the condition of a newborn baby are being studied:
- baby skin color;
- heart rate, i.e. pulse (HR);
- response to stimulus;
- muscle tone and reflexes;
- newborn breathing.
Each criterion is evaluated from 0 to 2 points, and the Apgar scale itself is presented in the form of a table. When summing up all five indicators, specialists of medical institutions receive the final result, which allows them to assess the condition of the baby in the first minutes of life and understand how well the child is adapting to the world around him.
A normal newborn baby makes 40 to 45 breaths per minute. Exactlysuch an indicator is estimated by experts at two points. In addition, the baby makes a cry, which also indicates the normal functioning of the lungs and also affects the result of the study. The doctor puts one point if the newborn cries, but does not scream, the voice trembles, and the breathing is slow. If there is no breathing or sound, the specialist scores zero based on the examination.
Heart rate estimation
A newborn baby's heart beats very fast. The process of childbirth for both mother and baby is a lot of stress, which is why the child needs time to adapt to environmental conditions. Normally, the heart rate of a baby born into the world ranges from 130 to 140 beats per minute. With these indicators, the work of the heart of a newborn is estimated at two points. The specialist of the medical institution puts 1 point if the newborn breathes slowly enough and his heart rate is low. This phenomenon may occur if the child had a lack of oxygen in the womb or the supply of oxygen to the body of the crumbs was impaired against the background of a difficult delivery process.
If there is no pulse, the work of the child's heart is estimated at 0 points.
Assessment of muscle tone and reflexes
It is known that in the womb of the child, by the end of the pregnancy, there is not enough space, and the position of the child becomes monotonous. That's whythe freedom of action acquired by the newborn leads to the fact that the first movements of the baby born into the world are chaotic, erratic. This is the norm. In this case, the doctor estimates the muscle tone indicator at two points.
If a newborn child keeps the upper and lower limbs in a bent position and makes movements with them only occasionally, the specialist puts 1 point according to the results of the study of the state of the baby's muscle tone. If there is no movement, the doctor gives 0 points.
In addition, the doctor assesses the presence of the main unconditioned reflexes of the child immediately after birth and their proper functioning. The presence of such is characterized by a cry and the first independent breath. A he alth worker observes a newborn's reaction to a stimulus.
In the complete absence of unconditioned reflexes, experts estimate this indicator at zero points. If outside help was used to express them, the doctor gives one point according to the results of the study of the reflexes of the newborn. The baby receives the highest score if the unconditioned reflexes manifest themselves without outside help.
How skin color is judged
Normal newborn skin color ranges from pale pink to bright pink. It is this skin tone that indicates the normal circulation of blood in the baby's body. In addition, the specialist assesses the color of the mucous membranes of the child, lips, palms and soles of the little legs of the crumbs. If the color of the baby's skin is pink without additionalshades, this indicator is estimated at two points. The child receives one point if his skin has a bluish tint. If the entire body of a newborn baby has such a shade, or if it is evenly white, the specialist puts zero points.
At birth, the color of the skin of the crumbs may have a bluish tint. After medical manipulations by a specialist, the baby's skin loses this feature. That is why the score obtained as a result of the secondary study is often higher than the original one.
If the baby's skin retains a blue tint for a long time, this should alert the specialist and become a signal for further research.
Score on the scale
The optimal state of the newborn is estimated at 7-10 points. A child's Apgar score of 5-6 points indicates the presence of slight deviations in the baby's condition. 3-4 points characterize the average deviations in the somatic state of the crumbs. And, finally, 0-2 points indicate that the child's condition is far from normal, and he needs constant supervision of specialists.
Deciphering the Apgar scale
To understand the results of the study, you need to find out what Apgar scores mean. Assessment of the fundamental indicators of the state of the newborn occurs twice: at the first and fifth minutes of life. That is why the second result may differ slightly from the original score. So, for example, at birth, the baby received 7 points, and after 5 minutes his condition wasrated 8 on the Apgar scale. It is worth noting that the difference between the indicators may differ not by one, but by several units, or may not change at all.
For example, at birth, the condition of the child required medical supervision as a result of difficult labor (or under other conditions) and was estimated at 6 points on the Apgar scale, and after 5 minutes the newborn adapted somewhat, and the initial indicator increased to 8.
It should be understood that the data obtained as a result of the examination of a newborn is not an assessment of the general he alth of the child and in no way indicates the mental pathologies of the baby. This test assesses the condition of the baby at the time of birth and allows you to understand how well the newborn has endured the birth.
The maximum score, 10 points, is extremely rare for newborns. The most common results are 7-8 points.
What factors can affect scores
The result of the study may be affected by the severe course of the delivery process, as a result of which the child had asphyxia. In addition, the cause of low performance may be hypoxia, which, in turn, can be chronic and acute. Chronic hypoxia accompanies the child throughout the entire period of pregnancy, it occurs due to malformations or pathologies of pregnancy. The acute form occurs during delivery.
In addition, a low Apgar score can be associated with many other factors - injuries and infections. So, for example, 7 points is estimateda mild form of brain damage in a newborn baby, a syndrome of increased neuro-reflex excitability.
Instead of a conclusion
Studying a newborn baby in the first few minutes after birth allows the doctor to understand the need for additional medical care for a child who has just been born, and enables a quick response in case of unforeseen situations.
It should be noted that the Apgar score does not characterize the overall he alth of the baby. What are these indicators for? The Apgar score can only predict the occurrence of various pathologies. But it is not a guarantee of the appearance of those.
The low result obtained as a result of the study of the crumbs should not lead the mother into a panic. Many factors can affect the result, including the characteristics of the course of childbirth.
Don't be upset if your baby gets low marks in a study. Indeed, in most cases it is subjective. Even the he althiest baby may not get the highest scores just because his limbs turned a little blue during childbirth or he did not cry loud enough.
Ratings below 5-6 points should be alarming. In other cases, nothing threatens the condition of the newborn baby.
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