Almost more than half a century ago, Virginia Apgar, an American anesthesiologist, spoke at the annual congress with a proposal to assess the health status of newborn children according to the method she developed. In the basis of many years of observation of newborns, V. Apgar laid down five characteristics, according to which it is necessary to examine a child in the first minutes of his life outside the mother's body.

Apgar scale and method of calculating newborns' scores

Depending on the results of the test, it was determined whether the child needed a resuscitator. At first, the Apgar scale was introduced into medical practice for nurses who help a doctor during childbirth. But soon the method gained such popularity that it went far beyond the confines of American clinics. In 1963, pediatrician Joseph Butterfield, in order to memorize the necessary characteristics, correlated their names with the first letters of the Apgar surname, so that it would be more convenient for English-speaking doctors to memorize the main parameters.

The scoring methodology consists in assessing five vital characteristics of a newborn and correlating them with tabular data.

For each characteristic, you can get from zero to two points:

• «0» placed only when the feature is absent;
• "1" - if the sign is practically not expressed;
• "2" - if the indicator is "normal".

To give the initial child, the number of respiratory acts, heart contractions, muscle tone, the manifestation of vital reflexes, and the color of the skin were chosen.

To conduct such studies, the child is visually examined in the delivery room in the first 60 seconds from the moment of birth. If any indicators are low, then the baby can be tested at the fifth and tenth minutes after birth..

Apgar scoring table at birth and detailed explanation

Apgar Scale - How to earn points and what they are given for. What does the Apgar score of a child affect?

The state assessment table shows how many points a given indicator gives. The sum of these points is the overall Apgar score.

Let's consider each feature in more detail ...

• Palpitations ... In a newborn baby, the heart beats more often than in an adult, actively enriching the blood with oxygen. After all, now the child needs to ensure his life on his own, which means that the work of all organs and systems will take place in an enhanced mode for a small organism. In addition, do not forget that childbirth is stress not so much for the mother as for the child, who adapts to new living conditions outside the mother's body. The average heart rate in newborns ranges from 130 to 140 beats per minute. With such indicators, the baby will receive the highest two points. If the baby did not receive enough oxygen in utero and there was a protracted labor, then his heart will work a little slower - one point is given for this. If the heart is not bugged, then the score will be 0.
• Breathing rate ... Trying to get enough oxygen, the child will produce more breathing movements per minute than older children do. At the same time, you should not be intimidated by such convulsive breathing of the baby - it will be normal for him to perform from forty to fifty respiratory acts per minute. That is, every second the baby receives a new portion of oxygen. Doctors evaluate such a toddler at 2 points. With slow, shallow and irregular breathing, the child is rated one point. This means that the labor process dragged on and the baby experienced a state of hypoxia. If the baby does not cry or breathe at all, he is given zero points.
• Muscle tone ... Another characteristic by which newborns are judged. Babies tend to have increased flexor muscle tone, as they have spent nine long months in embryo position waiting to be born. And with this event, the child tries to randomly move his arms, bend his fist, as if he wants to stretch from a long lying in the womb. These movements show that the baby is healthy, his muscular system adequately responds to external stimuli.
• Reflexes - a vital indicator that is laid down by nature. The child performs reflexive actions without realizing it. Such important reflexes in the first minutes of life as inhaling, screaming, sucking and swallowing milk are the main skills that provide a start in life for a baby. Without these reflexes, he cannot learn something - this is given to him by nature. If all reflexes of the child are fast, active and occur in full, then he deserves the highest mark of 2 points. With insecure, inhibited reflexes, the baby gets 1 point, and in their absence - 0.
• Color of the skin ... Usually, with sufficient oxygen supply to the child, his skin color is healthy pink, and with a lack of oxygen, it acquires a bluish-purple hue. Depending on the color of the skin, the child is also given points from zero to two.

Apgar test results and assessment of the child's condition

Points total

• Seven to ten assigned to healthy babies.
• Five to six - toddlers with mild deviations.
• Three to four - with average health deviations.
• From zero to two - with strong deviations.

Focusing on these indicators, the medical staff decides on the need for assistance by a resuscitator, a neonatologist, as well as on the follow-up of a pediatrician, etc.

It is important for young mothers to remember that the Apgar score is subjective, and it is intended not so much for parents as for doctors.

Only recently have our young mothers started to brag to each other about the Apgar indicator, and earlier this information was more important for doctors than for patients.

I must say that it does not mean at all that a child who received Apgar lower than another baby is sick or has any deviations. Most often, intrauterine hypoxia and protracted labor underestimate the assessment. However, with normal oxygen supply, the baby will quickly restore its functions and give odds to all "excellent students".

Apgar scale for newborns is a modern way of assessing the readiness of infants for extrauterine life. The first exam will not affect your love for the baby, but it will not hurt to learn about the intricacies of passing it, the meaning of the mysterious numbers in the discharge from the hospital. Let's talk in more detail about what the Apgar scale is, how to decipher it and what to do if the baby received low marks.

In this article, you will learn

What does this scale mean?

A scale for assessing the health of a newborn based on external signs is necessary for obstetricians-gynecologists, pediatricians present at childbirth. According to the results of the examination and the summing up of points, a decision is made on the obligation to provide the baby with emergency resuscitation care, on the possibility of transferring it to the woman in labor in the ward of joint stay.

The APGAR system was developed in 1952 as a teaching material for students, an aid in the work of nurses. The innovation was given the name of the creator - an anesthesiologist Virginia Apgar, professor. The increasing number of births of children with intrauterine pathologies and suffocation during childbirth demanded to invent the rating. And it has been successfully used in obstetrics and pediatrics for 70 years.

Apgar scale - a range of points from 0 to 10 points. The child is examined twice in the first and fifth minutes after birth, grades are assigned according to 5 indicators:

1. epidermis color- A (Appearance);
2. heart rate- P (Pulse);
3. reflexes, reflex excitability- G (Grimace);
4. muscle tone, physical activity- A (Activity);
5. breathing pattern- R (Respiration).

For each item, the baby gets from 0 to 2 points. After the points have been added up, the result on the Apgar scale is ready. If the result of the examination at the fifth minute is equal to 0–7 points, then the assessment is carried out three more times after an equal period of time: at the 10–15–20th minute. Determination of the result takes less than one minute, no additional equipment is required.

In the postnatal discharge, the child has at least 2 indicators on a scale, for example 7/9 or other numbers. This will mean that in the first minute he received 7 points, and in the fifth - 9. For a positive assessment of the result, it is important to see the dynamics of adaptation (the first numbers will be less than the subsequent ones).

More about each parameter

Assessment of the state of the newborn is based on external signs of the body's vital activity. To understand how this happens, let's dwell on each point in more detail.

Obstetricians, pediatricians use the table to quickly obtain a result on the Apgar scale. It looks like this ( Attention! The table can be scrolled left and right):

The result of the assessment is the summation of points for each indicator. It happens as follows:

• Color of the skin

If the newborn has a light pink, hot pink skin tone, it gets 2 points. The bluish shade of the extremities with the normal color of the epidermis of the rest of the body reduces the score to 1 point, signaling the doctor about weak fetal hypoxia.

The blue color of the skin is everywhere, excessive pallor is a reason to carry out resuscitation procedures and put 0 points on the first indicator.

It is interesting! By the way, children born through a cesarean section are more likely to receive a maximum of 2 points according to this criterion. This is due to the fact that the natural passage of the birth canal is not easy for an infant and can affect the level of oxygen in the tissues. And the Caesarites manage to avoid this.

• Pulse

Heart rate is measured 6 seconds after birth by listening, palpation of the chest or palpation of the arteries. Then multiply the resulting figure by 10, so you get a minute result.

The heart of newborns works actively. The norm is considered to be a pulse in the range from 130 to 140 beats per minute. In this case, the child earns 2 points.

If the heart beats unstable, slower, the baby gets 1 point, if there is no pulse at all - 0 points.

If the indicators are not normal, then the baby is undergoing resuscitation procedures until the heart rate returns to normal.

• Reflexes

The ability to suck, grab, swallow, breathe are the first reflexes of newborns that are necessary for life. If the child clearly shows the presence of these innate skills in the first minutes of life, then he gets a high score of 2 points. The baby must look for the breast, smack his lips, scream after birth, breathe.

If reflexes are weakly or partially expressed, then he earns 1 point, in their complete absence - 0 points.

To obtain an objective assessment, obstetricians stimulate the manifestations of reflex movements:

• put a finger on the lips of the baby;
• put the newborn on a flat surface, prompting to step;
• laid on the tummy and pushed under the heels, awakening the crawling reflex;
• a catheter is placed to clear the nose of mucus; great if the baby sneezes, grimaces, removes the head.
• Muscle tone

Chaotic movements of the arms and legs are the main indicator of the well-being of the baby immediately after birth. He seeks to straighten the limbs, bring the body to a normal position. This behavior adds 2 points to the total.

A baby gets 1 point if:

• moves weakly, but does it reluctantly;
• handles, legs remain in a bent position.

With a complete absence of body movements, maintaining the position of the embryo or close to it - 0 points.

• Breath

A baby earns 2 points if he screams shrilly after birth and in the first minute of life maintains a normal breathing rhythm - 40–45 breaths. If, instead of crying, the newborn makes a groan, wheeze, breathes unevenly, he will be given 1 point, in the absence of manifestations according to this criterion - 0 points.

Important! It should be borne in mind that premature babies born unnaturally, and through a cesarean section, receive lower Apgar test results. Women should not be upset about this, inventing shortcomings for the baby. Attention, care and careful grooming can quickly remedy the situation.

What grades mean

In delivery, women are usually not given accurate Apgar scores. Parents see the result in the card after being discharged home or ask the doctor. For self-decryption of the results, use the following decoding of the amount of points.

• 0-2 ... The newborn is in a critical situation, the help of a resuscitator is required.
• 3-4 ... The indicator is satisfactory. Deviations from the norm are average. Premature babies often get this result. After birth, the baby is monitored by a pediatrician, obstetrician, and neurologist.
• 5-6 ... Satisfactory result, small deviations from the norms.
• 7-9 ... The indicators are optimally positive. Deviations are weak.
• 10 ... Healthy child.

To simplify the algorithm for evaluating the results, we give examples of the results of testing newborns:

• 8/9, 9/9, 9/10

The baby feels wonderful. Doctors and mothers do not need to worry about his well-being, closely monitor his condition until he is discharged from the hospital.

The clinical result is normal. The kid feels well, he quickly adapted to the external environment.

• 7/8, 6/7, 5/7

Perhaps the baby was born a little weakened, but quickly rehabilitated by the fifth minute. Feels good, medical attention and close supervision of a pediatrician is not required.

Satisfactory performance. No urgent medical attention is needed.

• 6/6, 5/5

The condition is average, pediatricians need to monitor the newborn more closely.

• 4/5, 5/6

The result is below average, but there is a positive trend. The child is observed more closely 1–2 weeks after discharge.

• 4/4, 3/4

This result requires measurement at the tenth minute after delivery. The physical condition of the baby is poor. In this case, the woman and the child are placed in a hospital for further observation.

• 2/3, 3/3

Need resuscitation, critical condition.

• 2/2, 1/2

The child has clear signs of asphyxia, there is a threat to the life of the newborn. Pediatricians must perform urgent resuscitation.

• 0/2, 0/1, 1/1

The situation is difficult, the baby is on the verge of life and death. It is impossible to do without resuscitation, a detailed examination.

It is interesting! A score of 10 is given to newborns in Russia very rarely. This is due to the mentality of the medical staff, the fear of jinxing, showing unprofessionalism. Thus, 9 points can correspond to 10 accepted internationally.

What is considered the norm

Assessment of the newborn according to the Apgar scale is a worldwide method for identifying defects in the intrauterine development of infants. In obstetrics, he was loved for his objectivity and simplicity. The sum of the points allows you to get a complete clinical picture of the baby's condition, draw up a plan of observation and postpartum care for him.

Points are considered normal indicators of the level of physical and reflex development. from 7 to 10... In this case, the baby does not require medical attention, it is transferred to the woman in labor, applied to the breast.

• 5-6 - minor deviations;

It takes time for rehabilitation, often the shortcomings are of a one-time nature. Associated with asphyxia, fetal immaturity.

• 3-4 - the general condition is unsatisfactory;

There is an average degree of oxygen starvation of the baby. Resuscitation procedures will be required to bring breathing and pulse back to normal rhythm.

• 0-2 - critical situation;

There is a risk of death of the newborn. First of all, breathing stimulation (IVL) is carried out. Low body weight, prematurity, hypoxia may be the reason for low rates.

The level of manifestation of the Apgar scale criteria is determined twice: at the first and fifth minutes. At low rates, it is important to observe positive dynamics. If a child received 4–5 points in the first minute, but 7–9 in the fifth, then he is considered a healthy child. Lack of dynamics is an alarming sign, a reason to take measurements two or three more times, to provide the baby with urgent resuscitation assistance.

It is important to understand that the Apgar test is subjective for the further development of the baby. Toddlers with a score of 9-7 are not necessarily smarter, stronger than those with low scores.

What if the score is low

Early diagnosis of a newborn's condition is a lifesaver for modern obstetricians. The Apgar rating indicates the level of well-being of an infant in the first minutes of life. Of course, all parents hope for the birth of a healthy, strong baby, which means high marks on the scale.

Low scores indicate the presence of congenital malformations, poor adaptation of the infant to the external environment. The reasons for negative results are most often:

• Asphyxia is suffocation. It occurs as a result of entanglement of the fetus with the umbilical cord, obstruction of the respiratory tract with mucus, amniotic fluid.
• Hypoxia is a lack of oxygen during the prenatal period. Oxygen is lost to the brain and tissues. From here appears cyanosis of the skin, edema, low physical activity in the first minute of life.
• Prematurity. Physiological immaturity, underweight.
• Birth injury. A healthy fetus suffers from the passage of the birth canal.
• Intrauterine infections. Passed from mother to fetus.
• Incompatibility of the blood of the mother and the fetus. The risk of Rh-conflict.

Asphyxia and hypoxia are considered especially dangerous. A prolonged lack of oxygen leads to serious developmental disorders of the child in the future, provokes serious neurological diseases, such as:

• Syndrome of increased reflex and nervous excitability... It persists in children under 3 months of age. Babies are restless, often cry, sleep poorly. Reduced or increased muscle tone, chin and limb trembling are recorded.
• Convulsive syndrome... Leads to epilepsy. It is characterized by an involuntary contraction of one or a group of muscles.
• Comatose Syndrome... Consciousness, sensitivity, motor function are suppressed.
• CNS depression... Reflexes are weak, the baby sleeps a lot, eats little.
• Hydrocephalus... Fluid accumulates in the brain of a newborn. A lag in physical and mental development is diagnosed.

Birth trauma causes cerebral palsy, VSD, hypertension, motor disorders. The consequences of intrauterine infection are difficult to predict. These are various diseases of hearing, vision, internal organs, stillbirth.

Babies with hypoxia or asphyxia are born weak and passive. The Apgar test result is measured two to four times and is no more than 6 points. With the organization of proper care, the provision of professional medical care, and the observance of the recommendations of pediatricians, the normalization of the baby's condition is possible. And the quality of life of the child and the parents will depend on this.

Important! Low Apgar test results in premature babies correspond to the average in those born on time, unless there are serious reasons for concern. For example, 6/7 in immature infants is the norm. But regular observations by a neurologist and other narrow specialists will still be required.

Don't be discouraged if your child's Apgar scores are lower than the maximum. After all, all the most important for its development will be laid down further - in the first years of life. And much will depend on your love and desire to raise your child healthy and happy.

IMPORTANT! * when copying the materials of the article, be sure to indicate the active link to the first

Apgar scale for newborns is a system for the first assessment of the health of a newborn baby. Doctors conduct such an assessment in the first minutes of life. The first Apgar score is given in the first minute after birth. The second mark is given in 5 minutes. As a result, the Apgar score consists of two numbers that the doctor sets when examining a newborn.

The Apgar score allows the doctor to determine whether a newborn needs special care. But besides the doctor, it is also important for the mother to know everything about the state of health of her child. In this article we will tell you how to decipher the Apgar scale, which means the scale points for newborns.

The system for assessing the state of the newborn is a table in which five main criteria for the state of health are entered with an assessment of each from 0 to 2 points. The sum of points on the Apgar scale can range from 0 to 10 points. Let's look at the main criteria of the Apgar scale.

The main criteria for the state and functioning of the child's body, according to which points are given:

1. Heart function (heart rate) - count the heart rate per minute. In newborns, the heart works more intensely than in adults, so ideally the result should be 120-140 beats per minute.
2. Breath- the presence of breathing and its intensity are determined. Normally, a newborn makes 40-45 breaths per minute, accompanied by a shrill cry. With irregular and slow breathing, high scores (9.10 points) are not given.
3. Muscle tone- assessed by the intensity of the newborn's motor activity. The more actively the newborn twists with legs and arms, the higher the Apgar score.
4. Reflexes of a newborn- the presence of unconditioned reflexes in a newborn (sucking, swallowing, grasping, etc.) is assessed. But the main reflexes are screaming and inhaling. If the child screams loudly, sneezes clears his throat - that's good! If the baby sucks on to the mother's breast and the fingers on the arms are tightly clenched into fists - this is also very good! There are other unconditioned reflexes that the doctor evaluates (read more HERE)
5. Color of the skin- the color of the child's skin is assessed, special attention to the palms, feet, lips and oral mucosa. With a pink color of the skin (from light to reddish), it is estimated at 2 points, if cyanosis of the skin is noticed - 1, pallor of the skin with a bluish tint - a score of 0.

Each criterion is evaluated, the points are summed up.

Apgar scores

The scale for assessing the primary condition of newborns was developed by an American, an anesthesiologist Virginia Apgar... The Apgar scale was introduced into practice back in 1952. Since then, all newborns have their own personal assessment at birth.

Naturally, the more points on the Apgar scale in total the newborn received, the better. The best total score is 9 and 10 points. How to decipher Apgar scores?

Decoding points on the Apgar scale

As we already wrote, the assessment of the child's condition on the Apgar scale is carried out two times: at the first and fifth minutes after birth. Most often, the second grade is 1-2 points higher than the first grade. This happens because the child has got used to it a little, has adapted to new conditions for himself.

0 points on the Apgar scale

If the child was given 0 points, then the child was born dead.

1 point, 2 points on the Apgar scale

When assessing 1-2 points, the child's condition is regarded as extremely serious. There is a threat to the life of the newborn.

3 points on the Apgar scale

The child's condition, assessed at three points in 5 minutes, is a critical condition. Your baby needs resuscitation or other urgent medical attention

4 points on the Apgar scale

If the child was given a score of 4 points at birth, then the child's condition is assessed as serious. The newborn needs constant monitoring by doctors.

5 points on Apgar

Five points is below average. The child's condition requires medical supervision for at least 5-7 days. Medical assistance is provided according to the situation of examinations.

6 points on Apgar

With indicators of 6 and 7 points, doctors conduct additional follow-up examinations every 5 minutes for 20 minutes and watch the dynamics of changes. In this state, the child may need help for the child at any time (i.e. examinations are carried out at the 5th, 10th, 15th, 20th minute of the child's life).

7 points on Apgar

In the first minute, an Apgar score of 7 is characterized as "no visible pathologies", but better than 8, 9 or 10.

8 points on the Apgar scale

If the child was given 8 points even at the 5th minute, this is considered the maximum norm and the child is handed over to the mother.

9 points on the Apgar scale

Nine points at birth is a very good indicator. You have nothing to worry about as the baby is feeling great!

10 points on the Apgar scale

The Apgar score of 10 at the 1st minute is extremely rare. Ten Apgar points in the fifth minute say that the child's health is perfect!

10/10 points - not found in practice.

Newborn Assessment Chart

Apgar scores

According to the table, we can conclude: if the child was given 7, 8, 9, 10 points on the Apgar scale at the first minute of birth, and 8, 9, 10 points at the fifth minute, then this is good. With indicators of 7/8, 8/8, 8/9, 9/9, 9/10 or 10/10 points, you should not worry, the state of health is in perfect order.

Apgar scores 5/7, 6/7 and 7/7 points are not an indicator of the presence of a pathology in a child. These scores also do not indicate serious impairment or disability. These points speak of presence of certain problems... Which ones - the doctor will tell you about this. In addition, scores from 5 to 7 points require increased attention to the child. Your child will most likely need additional testing.

But, in premature infants, the criteria score is lower than in full-term, so a total score of 6 or 7 is a good result for them.

When assessing 5-6 points, the child needs careful observation by doctors, and special treatment measures are often required. After discharge, the child is sent for examination to a neurologist.

When evaluating less than 5 points the condition is assessed as severe, hypoxia occurs. Most often, a newborn needs resuscitation. Such children are transferred to the hospital and are not discharged until the condition improves. to score 7 points on the Apgar scale.

A low final result (up to 5 points) is a cause for concern for the mother and the doctors. But the average score on the Apgar scale is from 5 to 7 points should not lead to panic- just such children need additional examination by a neurologist and other specialists. This indicator is important only in the hospital and for the district pediatrician.

It is clear that every mom wants to hear about a score of 9 or 10 points on this scale. However, there is no need to waste your nerves, it is better to take care of your baby!
In the future, this assessment, with proper care, will not affect the child's health in any way!

An Apgar score is a check on the condition of a newborn immediately after birth. Doctors diagnose the infant for the need for resuscitation therapy in the event of a difficult birth. Indicators of the Apgar scale are reported to mothers and fathers along with the weight and height of the newborn baby.

What is checked and evaluated in a newborn baby in the first minutes of life?

Evaluated:

• breath;
• pulse beats;
• muscle tone;
• manifestation of congenital reflexes;
• skin color.

Next, the baby is weighed, the height and circumference of the chest and head are measured. And what is the Apgar scale, why is it needed? This system was developed by the doctor Virginia Apgar in 1952. She presented evidence-based conclusions based on long-term analysis of the condition of newborns and recorded her observations on a ten-point scale.

For the parents of the baby, the scale points do not mean anything: they are intended for pediatricians. Young mothers and fathers should know that a score of 7 to 10 points indicates the normal state of a newborn baby.

Some parents believe that this assessment shows the mental development of the baby, but this is a mistake and delusion. How can you assess mental development in the first minutes of a baby's life? All the more absurd is the opinion that the scale gives an assessment of the appearance of a baby!

Healthy or Viable?

Assessment of a newborn on the Apgar scale does not reveal the state of health of the baby. It characterizes the vitality of the newborn: will he live? If the total indicator is below seven points, the baby is given resuscitation procedures.

If right after birth the baby was put on the mother's belly and allowed to attach to the breast, then there is nothing to worry about!

A high score on the Apgar scale (8-9 points) indicates the viability of the baby, its dynamics and the presence of congenital reflexes.

Why is the baby given a double grade, for example, 8/9 points? Because the newborn is tested twice - immediately after birth and five minutes later. Often the second grade is 1-2 points higher than the first. This informs that after the stress suffered, the baby managed to get used to the new world and decided to show all his capabilities.

Mom herself can check the presence of reflexes in a baby:

1. The crawling reflex is checked as follows: if you put the baby on the tummy and rest on the legs, it will start to push off.
2. The automatic gait reflex is checked as follows: take the newborn under the armpits and place it on a flat surface, slightly tilting forward - he will take a reflex step.

Important! Many parameters of a baby's development depend on the mother's care and effort. It is important to notice and eliminate negative moments in time.

Indicators of the vitality of the baby

Let's analyze the value of the vitality indicators of the crumbs on this scale.

1. Breath... If the baby cried out loudly right after birth, it means that the lungs have been activated. After shouting, two points are assigned. If the baby did not scream, but cried with a trembling voice, one point is assigned. If the baby does not scream or even breathe, zero points are assigned.
2. Palpitations... The heart rate of a newborn is characterized by an accelerated pace - up to 142 beats per minute. With indicators of the work of the heart over 100 beats, 2 points are assigned. At a low frequency of work of the heart muscle, one point is assigned. In the absence of a pulse, zero points are given.
3. Muscle tone. Immediately after birth, the baby's movements are chaotic, disorganized, and muscle tone is increased. Increased activity of movements is estimated at two points. Rare slow movements of a newborn baby are estimated at one point, absence of movements - zero points.
4. Reflexes... The first breath and cry are unconditioned innate reflexes. The presence of such reflexes at birth is assessed by two points. If reflexes did not appear immediately, but were caused by the efforts of doctors - one point. Lack of reflexes - zero points.
5. Color of the skin. The normal color of the skin is pink, it characterizes the active work of the circulatory system of the baby. With a bluish shade of the limbs and oral mucosa, one point is given. With a uniformly cyanotic or pale shade of the entire skin of the body - zero points.

So, the normal state of the newborn can be judged by the following indicators: the baby should have a pink skin color, scream on its own, turn away from the bright light and resist the doctor's flexion / extension of the limbs. In this case, the rhythm of heart beats should be moderately frequent - 100 contractions of the heart muscle per minute.

Low rates

What if the Apgar score was low? Do not worry! Do not think that the baby was born disabled and you will have to suffer with him. These indicators record the state of the baby after childbirth: how he transferred the passage through the birth canal.

These indicators inform about the urgency of carrying out resuscitation procedures for the newborn. For example, if a baby is pulled for a long time with forceps, he gets oxygen starvation. What will happen after such manipulations? The baby is unlikely to be able to scream right away, and the skin will have a bluish tint.

Scheme for assessing the condition of the newborn:

• 7-10: excellent condition;
• 5-6: slight deviations;
• 3-4; deviations of moderate severity;
• 0-2: serious condition.

You should not worry in any case! Difficult childbirth is not a sentence for a baby, and soon all his vital signs will return to normal.

Mom must sacredly believe in this and not doubt! After some time, mom will see a rosy baby next to her with calm breathing and the presence of all the necessary reflexes!

Every modern woman in labor knows that when recording the parameters of a born child, the values ​​of weight, height and the assessment of the newborn on the Apgar scale are used.

If everything is clear with measurements of height and weight, then by what criteria is a mysterious assessment made?

An anesthesiologist from America, Virginia Apgar, has developed a special table to help her intensive care students, which allows in the first minutes of the birth of a child to determine the state and vitality of the baby as clearly as possible.

The purpose of the scale is to quickly assess the condition of a born child in terms of the need for resuscitation measures.

What indicators are being evaluated?

The state of the newborn on the Apgar scale is assessed according to five main criteria:

• Coloring of the skin of the body, limbs.

0 - Pale bluish color of the body and limbs.
1 - Partially bluish color of the limbs.
2 - Healthy pink color of the whole body.

• Heart rate per minute.

0 - Not present.
1 - Up to 100 beats per minute.
2 - 100 or more beats per minute.

• Reflexes.

0 - Does not respond.
1 - Weak reaction, sluggish movements, grimace on the face.
2 - Actively moves, coughs, sneezes, screams.

• Muscle tone.

0 - None, limbs drooping.
1 - The tone is reduced, weak movements of the arms and legs are observed.
2 - The tone of the limbs is actively expressed, vigorously moves the arms and legs.

• Breath.

0 - Does not breathe.
1 - Shallow, irregular breathing, weak cry, slow breathing.
2 - Breathes normally, screams loudly.

For each criterion, the obstetrician and neonatologist give the child 0, 1 or 2 points. The final figure is the sum of points for all parameters of the Apgar table.

The assessment of the child's condition according to the Apgar scale is put in 1 minute after the birth of the fetus. The second point is the same parameters assessed at the 5th minute.

Sometimes, at very low rates, doctors give a third estimate at the 10th minute of an independent life of a newborn. Parents are usually given a double score, such as 7/9.

3 or less points on the scale indicate the unfavorable condition of the child and the need for special life support measures.

7 points and above - the child is normal, viable, has a good chance of gradually adapting to an independent life.

Decoding the Apgar scale

Assessment of the condition of the newborn helps doctors, if necessary, to quickly take measures to support the child:

• From 0 to 2 points.

The child's vitality is at stake. Immediate resuscitation measures are required.

With the provision of timely professional assistance, the baby shows the best Apgar score 5 and 10 minutes after birth.

Subsequently, the baby will need more careful care and supervision. However, it is believed that "Losers" are also able to become physically strong and smart kids in the future.

This is how premature babies are usually evaluated. If at the 5th minute the condition does not improve, resuscitation is required, as well as special attention and care in the first weeks of life.

The condition of the newborn is considered satisfactory. The child will need close medical supervision during the first week of life.

If the condition at the 5th minute of life has improved to 7-8 points on the Apgar scale, then stay in intensive care is not required.

Optimized assessment of the child's vitality. The baby tolerated childbirth well, is not included in the risk group. Doctors only make sure that the process of feeding and weight gain is adjusted.

If the mother has enough milk and the child gains weight, then nothing threatens his condition.

• 10 points.

Highest score on the Apgar scale. In natural childbirth, the child rarely gets the highest score on all indicators.

An Apgar score of 9/9 is considered an excellent result. Russian doctors do not put 10 simply so as not to jinx it. In the reports of foreign obstetricians, you can often find the figure 10.

It is believed that under the same conditions of pregnancy, the Apgar score may be higher for "Caesareans", since they did not have to endure the stress associated with passing through the birth canal.

In 1963, pediatrician Joseph Butterfield used the letters of the Virginia Apgar surname as an abbreviation for better memorization of the Apgar scale table.

This mnemonic rule helps English-speaking specialists to keep in memory all the columns of the Apgar table:

1. A ppearance - view.
2. P ulse - heart rate
3. G rimace - facial expression, reflexes.
4. A ctivity - movement.
5. R espiration - respiratory activity.

Acronyms of the same nature exist among specialists in the German and Spanish language environment.

In American English, a neologism deciphering the abbreviation APGAR appeared - American Pediatric Gross Assesment Record (General American Pediatric Assessment System). We are talking, of course, about the system of assessing newborns famous among obstetrics around the world.

In the English-speaking environment, another principle of simplified memorization of Apgar scale data also operates - H ow R eady I s T he C hild (how prepared is the child)

• H eart rate - heart rate.
• R espiratiry effort - respiratory activity.
• I rritability is a reflex reaction to stimuli.
• T one - muscle tone.
• C olor - skin color.

Why does a healthy baby with an easy delivery not get 10 points on the Apgar scale?

Each child individually experiences the process of adaptation to independent life outside the mother's body. Evaluation of viability according to this table is considered objective, but there are also subjective factors:

1. In order for the baby's circulatory system to fully work on its own, it takes time - about 5 minutes. Before this time expires, the arms and legs may retain a cyanotic color.
2. There are cases when a big kid gets a low Apgar score only because he does not scream, but with interest and carefully examines the new environment in which he finds himself.
3. The professionalism of the doctor also influences the analysis of the situation in the first minutes after childbirth. This is just a test for the physiological criteria of the infant's viability.

Deciphering the Apgar score does not affect the physical development and intellectual usefulness of the child.

In the first year of life, birth scores of 8/8 or other possible combinations of ratings will be of interest to the pediatrician, pediatric neurologist and other highly specialized pediatric doctors.

Read also: