The need and importance of assessing a newborn baby on the Apgar scale.

Assessments, comparisons, comparisons, studies and conclusions are present in the life of every person from the moment of conception

• Nature is inherent in us curiosity and the desire to learn about the world around us. Therefore, we rely on the experience of our ancestors and our personal
• This means that one cannot do without assessments and comparisons. It is bad if this habit develops into backbiting, envy, antagonism towards other people.
• In this article, we will talk about the assessment of the condition of the newborn baby by medical staff in the maternity hospital, as well as the interpretation of its results.

Assessment of the state of the newborn on the Apgar scale: norms and criteria

table of criteria and values ​​according to Apgar scale

Apgar score is a determination of the physical condition of a newborn baby for the purpose of using / not applying urgent medical care:

• nursing in special chambers as, for example, in the case
• blood transfusion

There are many more options for emergency assistance to a just born baby. Therefore, medical personnel of average qualification are guided by Apgar estimates for decision-making.

Since 1952, the scale for determining the physical health of newborns, developed by the American anesthesiologist Virginia Apgar, has been adopted in world practice.

The criteria by which it is applied begin with the letters of the developer's surname:

• Appearance - skin color
• Ruls - the work of the heart
• Grimace - mimic contractions
• Activity - muscle activity and tone
• Respiration - breathing, a reflex response to irritation

The doctor subjectively gives points to the baby in the first and fifth minutes of life outside the womb.

Each criterion can score a maximum of 2 points. The total will be 10. But the maximum score is received by a rare baby. Statistics show that only 10-15% of newborns receive such an assessment.

How doctors give points only to a child who is born, let us consider in more detail.

• Heart work
  Normally, the contraction of the heart muscle in a newborn is more than 100 beats in 60 seconds. Such an indicator gets a two.
  If the pulse is diagnosed at 100 beats per minute - 1 point.
  When the work of the heart is less and the pulse has a lower rhythm, doctors set 0 and urgently connect the child with an oxygen mask to activate the work of the heart muscle
• Skin color
  An even pink skin tone in a newborn is a sign of good health and a successful course of labor. It is estimated at 2 points. Note that children after a cesarean section receive it more often, because they do not pass through the birth canal and do not give in to any pressure.
  Elements of a cyanotic shade and transparency of the skin, when capillary networks are observed, as well as bluish brushes of the arms and feet, receive a unit.
  If, in general, the color of the skin is more blue than pink, this is 0 and urgent hospitalization of the crumbs in the chamber for medical nursing
• Breathing in a newborn baby is quite frequent according to medical standards and is up to 45 exercises in 60 seconds. In this case, the baby receives two points on the Apgar scale, and the doctor begins to study the heart rate
  If breathing has a less rhythm, hoarse, then set a unit and help the child breathe through the installation of oxygen supply equipment.
  When there is no breathing at all, doctors urgently connect the baby's ventilator
• Muscle tone with a score of two is the physiological tension of the flexor muscles in a newborn, which is due to his posture in the womb. Therefore, the crumb gets the maximum rating, which lies completely grouped with the arms and legs pressed against the body.
• The doctor's attempts to straighten the arms and legs, elbows and knees of the child meet with weak resistance from the latter - which means that one will be exposed. The lack of tone in the crumbs means 0 points and a reason to sound a serious alarm
• Facial expressions and reflexes
  Almost all movements of a baby that have just been born are of a reflex nature. You can even put it on a hard surface and, holding it under your arms, see the steps. The situation is similar with crawling. If you put your palms under his heels when the baby is lying on his tummy, then he will push off from your hands and crawl. Loud screams and facial expressions are also bright in the crumbs, which were given the maximum score on the Apgar scale for this criterion.
  A weaker manifestation of reflexes in a child, instead of a cry - a groan, means one, and their complete absence - zero points and an urgent alert to doctors for emergency help.

Young parents should not sound the alarm about the first Apgar assessment of the physical condition of the newborn. Look at the indicators that doctors will collect in 5-10 minutes. If the dynamics of growth is observed, then everything is normalized.

What does a score of 0 on the Apgar scale mean?

a toddler with a low Apgar score in an intensive care unit

Zero is the absence of any movement and activity. It can only be delivered to dead tissue, a creature, a phenomenon, or a severely premature baby that requires urgent medical measures to awaken and maintain life in it.

What does an Apgar score of 1 mean?

• The birth of a baby before obstetric term is fraught with the risk of his adaptation to the new environment.
• In the case of oxygen starvation of the fetus during pregnancy and crumbs during labor, very low estimates of its health on the Apgar scale are expected.
• One indicates that only one of the five criteria shows itself weakly in the baby.

Therefore, the latter needs immediate resuscitation measures:

• artificial ventilation
• oxygen mask
• special heating lamp and / or closed capsule with special temperature conditions
• blood transfusion
• thorough and accurate cleansing of the respiratory tract from mucus

What does a score of 2 on the Apgar scale mean?

the newborn is placed in an incubator and breathes through special tubes

This assessment still cannot please either the young mother or the medical staff of the maternity hospital.

What does a score of 3 on the Apgar scale mean?

Three means that most of the indicators of the physical condition of the newborn are manifested. However, so far this is not enough to immediately go from the delivery room to the common room with the mother to establish contact and adapt the child to life in the air.

What does an Apgar score of 4 mean?

The range of scores 3-4 is a signal of the presence of deviations of medium complexity in the health of the newborn. Therefore, it will not be possible to do without resuscitation until it works, as well as without specific measures for caring for the baby after discharge.

What does an Apgar score of 5 mean?

baby with an average Apgar score on artificial lung ventilation

• The borderline health status of a newborn baby gets a grade of 5
• Doctors, according to the situation, make a decision on further caring for the baby, since all indicators on the Apgar scale received low scores
• If this assessment is given to the crumbs at the 6th minute of life, then you cannot do without nursing in the incubator

What does an Apgar score of 6 mean?

Six says that the physical condition of the baby is satisfactory.

In general, 5-6 on the Apgar scale is a slight deviation in the baby's health and therefore only needs some resuscitation measures.

In the presence of the dynamics of the growth of points in 5 minutes by 2-5 units, young parents do not have to worry about their child. It adapts well to the external air environment.

What does a score of 7 on the Apgar scale mean?

a doctor examines a newborn baby for Apgar scores

It is widely believed among physicians that the range of scores on the Apgar scale of 7-10 points can be considered the norm, an indicator of the child's good health and the successful course of pregnancy and childbirth.

What does an 8 on the Apgar scale mean?

The most common score reflecting the good physical condition of the newborn both in the first and fifth minutes of life outside the mother's body.

An eight means that all five signs are manifested, but some of them are less pronounced, for example, the first cry was quiet and the color of the skin has a bluish tint in places.

What does a score of 9 on the Apgar scale mean?

A very good overall score for the state of physical processes of just a born baby or after the first 5-10 minutes of his independent life.

The nine speaks of the well-coordinated work of the basic systems and reflexes of the baby, adjusted for a specific indicator, which the doctor visually assessed a little lower.

What does a score of 10 on the Apgar scale mean?

first examination and Apgar assessment of an active newborn baby

• Doctors rarely set the maximum Apgar score.
• If your baby has received it, then his physical health can be equated to heroic health. And the story of his birth should be cited as a reference example of the birth of an absolutely healthy child.
• Whatever assessment the doctors give to your baby in the hospital, know that your love, care, attention and faith in the protection and help of the Higher Forces are capable of creating any miracle

Happiness to you and your children!

Video: Apgar Scale. What is this scale?

The Apgar scale is a point assessment of the child's condition after birth, designed to determine his basic vital functions and the need for resuscitation. The Apgar score, along with weight and height, is reported to the parents after the baby is born.

The Apgar assessment of the newborn was developed and proposed in 1952 in the United States by anesthesiologist, Professor Virginia Apgar. The Apgar score was proposed for the rapid assessment of newborns; Apgar scores mean the presence of several vital signs and an assessment of their severity.

There are five signs in total, and they can be assessed from 0 to 2 points. 0 points - no sign, 1 point - weakly expressed, 2 points - pronounced. Apgar scores are summed up, and a figure from 0 to 10 is obtained, however, there are practically no ideal 10 points in the first minute of life.

Assessment of newborns on the Apgar scale quickly gained popularity all over the world due to its practicality, accuracy of assessing the condition of newborns, and the absence of the need to use any equipment. It is carried out by an obstetrician, a neonatologist who received or is present at the birth.

The assessment of the child on the Apgar scale is carried out in the first minute of life and after five minutes... Changes in the state of the newborn, its adaptation in the external environment occur quite quickly, and 5-6 points on the Apgar scale in 5 minutes can rise to 9-10 points. If necessary, delayed normalization of the child's condition, the assessment can be repeated 10 minutes later, after resuscitation and assistance to the newborn.

The score made is recorded as follows: Apgar scale 7/8 points, two scores through a fraction, the first - in the first minute, the second - in the fifth minute.

How to interpret the Apgar score:

- 7-10 points - the child was born healthy and perfectly adapted.
- 5-6 points - there are small deviations in the state of health, the child requires the attention of a doctor.
- 3-4 points - a serious condition requiring immediate medical attention.
- 0-2 points - an extremely serious condition, the child will die without resuscitation measures.

Below is the Apgar table, which is used for the assessment.

The Apgar scale for assessing the condition of newborns allows medical workers of a maternity hospital to determine whether a newly born child needs their help.

Often, Apgar scores also help pediatricians who look after a baby later to monitor a specific aspect of the baby's condition. The article below contains information about what is the essence of this technique, as well as how exactly each of the aspects of a newborn's life is assessed by specialists.

The Apgar scale (newborns are assessed with its help a minute after birth) is considered the fastest comprehensive system for determining the need for resuscitation procedures in each specific case. Traditionally, it consists of 2, less often 3 "measurements" of the basic indicators of the baby's vital activity (1 minute, 5 minutes, less often 10 minutes after birth).

This need is due to the instability of the health status of newborns, which requires careful monitoring during the first minutes of a child's life. The essence of the technique is to assess the main criteria (1 or 2 points) and further summarize the results.

Research by obstetricians and neonatologists includes:

• the skin, in particular its color;
• the quality and quantity of heartbeats capable of recording significant deviations in the functioning of the cardiovascular system of a small person;
• the presence of reflexes, as well as their "liveliness";
• the tone of the muscle corset of the baby's body, the activity of the limbs is of particular importance;
• the baby's respiratory system, namely its ability to independently fill the lungs with air and exhale it without holding it in the body for a long time.

In the presence of significant deviations in the functioning of the above systems and organs of the child (Apgar score less than 5), medical specialists, in the vast majority of cases, decide to closely monitor the baby's condition in dynamics. In such a case, the child, as a rule, goes to the mother not earlier than the second day after birth.

Indicators of the normal state of the newborn in the table

The Apgar scale (newborns using this technique began to be assessed back in 1954) illustrates how much a newly born baby is ready for life outside the womb.

So, an absolutely healthy baby, ready to start independent life, is usually "awarded" 9-10 points according to Apgar (2 points for each of the criteria). Recently, the most common score is 8-9, which most often develops due to the decreased tone of the limbs in modern-day children being born.

The indicators of the normal state of the newborn are as follows:

Criterion / Apgar score	0 points on Apgar	1 point on Apgar	2 points on Apgar
Uniformity and saturation of skin color	Whole body white or blue skin color	Pink or red skin color all over the body, excluding the extremities (usually bluish)	Pink or red skin color of the entire body, including arms and legs
Cardiovascular function (heart rate)	Lack of heartbeat	Less than 100 per minute	More than 100 per minute
The presence and "liveliness" of reflexes	Complete lack of reaction	Weak reflexes	Active reflexes in the form of loud screaming, crying, sneezing, and so on
Muscle corset tone	Complete absence of minimal tension in the limbs (legs and arms sluggishly "hang down")	Slight tension, resulting in occasional slight bends of the legs or arms	Active change of position of arms and legs, "hardness" of the back muscles
Respiratory maturity	Lack of breath	Shortness of breath, absence or low cry at birth	Easily audible breathing, loud screaming, crying at birth

Decoding indicators: what deviations from the norms say

The Apgar scale, in particular the result of using this system, can help the parents of a newborn to form an idea of ​​the "strength" of their baby's health.

Having found out which of the evaluation criteria, in the opinion of neonatologists and obstetricians, did not deserve the highest number of points, mom and dad can assume that there are possible deviations in the general condition of the child, as well as, in some cases, the reasons for what happened.

Breath

The maturity of the lungs, expressed in the ability of the newborn to independently begin to inhale air after cutting the umbilical cord, indicates the normal development of the respiratory system.

The maximum Apgar score (2 points), traditionally, is "awarded" to babies who instantly cast a voice after birth, as well as to those whose total number of breaths and exhalations in one minute will be stable, amounting to at least 40-45 pulmonary contractions.

In the absence or minimal intermittent cry of the child after his birth, doctors give 1 point and observe the newborn during the first day of life.

In the absence of activity on the part of the respiratory system, neonatologists and obstetricians will immediately supply the baby with a system for artificial ventilation of the lungs and carry out the necessary resuscitation procedures in an attempt to bring the little person back to life.

Insufficient breathing intensity, as well as its complete absence, may indicate both the underdevelopment of the system itself (in the case of premature birth), and a violation in its functioning, most often due to "heavy" prolonged labor, usually leading to fetal hypoxia (a child in the birth canal suffers from a lack of oxygen).

Heart rate

By the number of heartbeats, the medical staff of the maternity hospital determines how much the baby has suffered in the process of birth. 2 points are usually deserved by children whose hearts beat more than 100 times per minute. The baby's heartbeat is less than 100 times per minute. usually seen in preterm labor.

Such a deviation from the norm indicates that the child's body is not ready to function separately from the mother's life systems. In the case of delivery on time, such disturbances in the cardiovascular system may be a consequence of prolonged fetal hypoxia during the process of birth.

In the absence of heartbeats in a newborn in the first seconds of life, doctors will attempt to resuscitate him. The reason for this may be, as a medical error; prolonged and traumatic childbirth, as well as infectious diseases of the mother, which provoked significant disturbances in the work of the child's cardiovascular system.

Muscle tone

In the case of ideal health of the newborn, the strength of his muscular corset will be reflected in motor activity. In the absence of violations, the baby will chaotically and quickly change the position of the upper and lower extremities, dynamically bending and unbending them. Moreover, the positive side will be the child's attempts to straighten his body, thereby bringing him into a natural position.

The basis for a less satisfactory result in the system of assessing a child on the Apgar scale (1 point) will be his unwillingness to move. In such children, as a rule, arms and legs are in a bent or, on the contrary, "hanging" position for a very long time after birth.

"Lazy" change of position of the body, extension of the trunk, are also considered a variant of deviation, as well as prolonged preservation of the embryo's posture or "lifeless" hanging of a child in the arms of an obstetrician or neonatologist.

The reasons for the deviation in the normal state of the muscle tone of the baby can be the consequences of difficult childbirth or birth trauma, damage to nerve endings, as well as improper formation of the muscle corset at the time of being in the womb.

Provided that all other evaluation criteria on the Apgar scale have a high score, excessive muscle tone or, conversely, muscular dystonia is corrected by physiotherapy, drug treatment, as well as the passage of several courses of massage, in accordance with the recommendations of the pediatrician and neurologist.

Reflexes

The presence of reflexes necessary for a separate existence is determined in a newborn by stimulating them by pediatric specialists who examine the child after birth. The maximum Apgar score is usually "awarded" to newborns who independently demonstrate a natural tendency to suck, grasp firmly, swallow, inhale and exhale air.

In the absence of visible reflex manifestations, obstetricians or neonatologists:

• bring the finger as close as possible to the lips of the baby, provoking him to suck;
• the child is placed vertically, with the normal development of which, the "walking" reflex should appear;
• a catheter is inserted into the newborn's nose to remove the remnants of mucus and other "products" of labor from the nose, prompting the little person to sneeze or, at least, try to turn away or show dissatisfaction with what is happening;
• position the baby on a hard surface, turning it over on its stomach and placing its hands on the child's heels, waiting for the crawling reflex to manifest itself, carried out by repulsion from the support.

The absence of reflexes in any manifestation indicates immaturity or significant injury to the nervous and muscular system of a person who has just been born.

Color of the skin

Ideally, the child should fall into the hands of neonatologists and obstetricians with an even pink color of the skin throughout the body. In the presence of a blue tint on the limbs, which is observed against the general background of the normal color of the skin surface of the newborn, doctors will check the baby for possible vascular injuries and nerve connections that disrupt the normal blood circulation in the child's body.

With excessive pallor, and in some cases, blue or blue color of the baby's entire body, neonatologists will immediately start resuscitation procedures to restore blood circulation. Deviations from the norm in this case are most often observed in children born naturally.

Caesarean section avoids the baby passing through the mother's birth canal, which is often the most traumatic stage of childbirth. Such features of the color of the skin of a child during natural childbirth indicate his suffering from a lack of oxygen at the time of "protracted" birth.

Algorithm for examining a child at birth

The Apgar scale (newborns are assessed exclusively by specialists) implies a certain algorithm for organizing the examination. Having accepted the baby from the "uterine" environment, the obstetrician or neonatologist makes an immediate assessment of the state of his skin.

Taking a look at the child's body, making sure of its uniform normal color, the specialist analyzes the presence of a cry in the baby. Having given no more than 30 seconds for the initial examination, the professional measures the heart rate, as well as the number and uniformity of inhalation and exhalation, using special medical equipment.

Then, having determined that the child's condition does not cause fear, it is applied (if possible) to the mother's breast. This method allows the doctor to assess the presence of natural reflexes, in particular to sucking. If the seizure of the nipple did not occur, they artificially try to "provoke" the child to demonstrate his own reflexes using the methods listed above in the article.

In parallel with these activities, neonatologists assess the muscle tone of the child, based on his motor activity while moving around the maternity ward in the hands of a specialist.

The re-assessment of the Apgar system indicators is carried out in the fifth minute of the baby's life. If the total score after the second examination is less than 7, doctors, as a rule, decide on an additional examination of the infant every 5 minutes. over the next 20 minutes

How are the points calculated?

Having given a certain number of points, indicating the ideal (2 points), satisfactory (1 point) or unsatisfactory (0 points) state of health of the newborn for each of the 5 basic criteria, the doctors summarize the numbers and receive the necessary assessment - a score on the Apgar scale.

What does 1-3 points mean?

The Apgar scale (newborns are examined with its help, regardless of the time and method of birth) makes it clear for parents an idea of ​​what state their child is in at the moment.

A score of 1-3 points is considered low and indicates strong deviations in the baby's health.

They can be triggered by the severe course of childbirth (the threat to life usually disappears several hours after the birth of the baby), chronic diseases of the newborn (occur when the mother does not follow a healthy lifestyle during pregnancy or she transmits infectious diseases), as well as the general immaturity of the systems of the child's body ( premature birth).

It is worth noting that in a number of cases, a low Apgar score necessitates emergency measures and the transfer of the little person to the intensive care unit.

What does 4-7 points mean?

The result on the Apgar scale, equal to 4-7 points, is, although not high, but acceptable. A child who has received such an assessment, as a rule, has moderate or mild health abnormalities, usually amenable to drug treatment.

Despite a number of dysfunctions that require correction, the consequences of such a state of the baby at birth, in his future life, in the vast majority of cases, are not observed.

What does 8-10 points mean?

8-10 points obtained as a result of summing up indicators for all basic criteria that are components of the Apgar system are considered the norm. This level illustrates the normal reactions and readiness of the newborn's body to begin life outside the uterine environment.

A child who has received such an assessment does not require additional examination and supervision by medical personnel and is transferred to the mother, provided that there is no need to provide her with postpartum medical care.

Forecast

Any assessment on this scale, seemingly objective at first glance, is set by one specific specialist and cannot be considered "the ultimate truth."

The figure shows the decoding of the Apgar scale.

That is why, even if the child receives a low Apgar score at birth, the mother should remember that following the recommendations of specialists, as well as unconditional love for her own child, can radically correct the situation.

The medical staff of maternity hospitals are adequately equipped to monitor and positively influence the deviations in the condition of the child at birth. Releasing the mother and the newborn from the institution after childbirth, doctors will make appropriate predictions for the further development and health of the baby, and will also give recommendations to parents in each specific case.

Apgar scale in examples

To form a detailed understanding of the condition of the newborn, it is advisable for parents to familiarize themselves with examples of Apgar estimates and their transcripts:

• 0/2, 1/2, 2/2, 2/3, 3/3 - the child's condition in this case is considered critical and requires immediate emergency medical care;
• 3/4, 4/4, 4/5, 5/6, 6/6 - the health of the baby with such assessments is unstable and requires careful monitoring by neonatologists and pediatricians, not only during the first few hours of life, but throughout the entire first month;
• 5/7, 6/7, 7/8, 8/8 - having received such assessments, the baby can be considered relatively healthy, but most often it has a general weakness and depletion of the body as a whole, which necessitates on the part of doctors to monitor its condition during the first day after birth;
• 8/9, 9/9, 9/10, 10/10 - indicators characteristic of absolutely healthy children who do not need specific care and supervision by medical personnel.

The Apgar scale, which has been used to assess the condition of newborns for many years, is the only relatively objective method for quickly determining the need for resuscitation measures for a baby.

Having carefully studied the above information, parents will be able to understand how experts assess the child's health using this system, and also whether it is worth worrying about the number of Apgar scores voiced by the doctors.

Useful videos about the Apgar scale and deciphering the assessment

What is the Apgar scale:

How is the assessment done:

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!

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.

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