The need and significance of assessing a newborn baby using the Apgar scale.

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

• Nature instills in us curiosity and a desire to learn. the world. That’s why we rely on the experience of our ancestors and our personal
• This means there is no way to do without evaluations and comparisons. It’s bad if this habit develops into slander, envy, antagonism towards other people
• In this article we will talk about the assessment of the condition of a newborn baby by medical staff in the maternity hospital, as well as the interpretation of its results

Assessment of the newborn's condition using the Apgar scale: norms and criteria

table of criteria and values ​​on the Apgar scale

Apgar assessment is a determination of the physical condition of a newborn baby for the purpose of using/not using emergency medical care:

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

There are many more options for emergency care for a newly born baby. Therefore, mid-level medical personnel rely on Apgar scores to make decisions.

Since 1952, a 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 last name:

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

The doctor subjectively assigns 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 is 10. But it is a rare baby who gets the maximum score. Statistics say that only 10-15% of newborns receive such an assessment.

Let’s take a closer look at how doctors give scores to a newly born child.

• Work of the heart
  Normally, the contraction of the heart muscle in a newborn is more than 100 beats in 60 seconds. This indicator gets a two.
  If the pulse is diagnosed at 100 beats per minute - 1 point.
  When the heart’s work is less and the pulse has a lower rhythm, doctors set it to 0 and urgently connect the child to an oxygen mask to activate the work of the heart muscle.
• Skin color
  Smooth pink tint skin in a newborn is a sign of good health and successful labor. It is worth 2 points. Note that children after caesarean section more often they receive it because they do not pass through the birth canal and do not succumb to any pressure.
  Elements of a bluish tint and transparency of the skin, when capillary networks are observed, as well as bluish hands and feet receive a unit.
  If the overall color of the skin is more blue than pink, this is a 0 and urgent hospitalization of the baby in a chamber for medical nursing
• The breathing of a newborn baby is quite frequent according to medical standards and amounts to 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 rhythm
  If the breathing has a slower rhythm and is hoarse, then they put 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 to a 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 maximum score is given to a baby who lies completely grouped with his arms and legs pressed to his body.
• The doctor’s attempts to straighten the child’s arms and legs, elbows and knees are met with weak resistance from the latter, which means a unit will be set. Lack of tone in a baby means 0 points and a reason to sound a serious alarm
• Facial expressions and reflexes
  Almost all movements of a newborn baby are of a reflex nature. You can even place it on a hard surface and, holding it under your arms, see the steps. The situation is similar with crawling. If you place your palms under his heels when the baby is lying on his tummy, he will push off from your hands and crawl. A loud cry and facial expressions are also vivid in the baby, who was given the maximum score on the Apgar scale for this criterion.
  A weaker manifestation of reflexes in a child, instead of a scream - a groan, means one, and their complete absence - zero points and an urgent alert to the doctors for emergency help.

Young parents should not be alarmed by the first Apgar assessment of the newborn's physical condition. Look at the indicators that will be collected by doctors in 5-10 minutes. If growth dynamics are observed, then everything will return to normal.

What does an Apgar score of 0 mean?

baby with a low Apgar score in the intensive care unit

Zero is the absence of any movement or activity. It can only be given 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 the obstetric term is associated with the risk of his adaptation to a new environment
• When oxygen starvation the fetus during pregnancy and the baby during labor are expected to have very low health scores on the Apgar scale
• One indicates that only one of the five criteria is weak in the baby

Therefore, the latter needs immediate resuscitation measures:

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

What does an Apgar score of 2 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 an Apgar score of 3 mean?

Three means that most of the indicators of the newborn’s physical condition are manifested. However, this is not yet enough to immediately move from the delivery room to a shared ward with the mother to establish contact and adapt the child to life in the air.

What does an Apgar score of 4 mean?

A score range of 3-4 is a signal of the presence of deviations of moderate complexity in the health of the newborn. Therefore, it will not be possible to do without resuscitation, as well as without specific measures to care for the baby after discharge.

What does an Apgar score of 5 mean?

baby with average Apgar score on mechanical ventilation

• Borderline health status in a newborn baby receives a score of 5
• Doctors decide according to the situation further care little by little, since all indicators on the Apgar scale received low scores
• If this assessment is given to a baby at the 6th minute of life, then nursing in an incubator is indispensable

What does an Apgar score of 6 mean?

Six says that physical state crumbs are satisfactory.

In general, 5-6 on the Apgar scale means slight deviations in the baby’s health and means he only needs some resuscitation measures.

If there is a dynamic increase in scores after 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 an Apgar score of 7 mean?

Doctor examines a newborn baby to give Apgar scores

There is a widespread opinion among doctors that the range of Apgar scores of 7-10 points can be considered the norm, an indicator good health child and successful pregnancy and childbirth.

What does an Apgar score of 8 mean?

The most common score, reflecting the good physical condition of the newborn in both 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 not loud and the color of the skin in some places has a bluish tint.

What does an Apgar score of 9 mean?

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

Nine speaks of the coordinated work of the baby’s basic systems and reflexes, adjusted for a specific indicator, which the doctor visually rated a little lower.

What does an Apgar score of 10 mean?

first examination and Apgar assessment of an active newborn baby

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

Happiness to you and your children!

Video: Apgar scale. What scale is this?

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

The Apgar assessment of a newborn was developed and proposed in 1952 in the USA, by anesthesiologist, Professor Virginia Apgar. The Apgar score has been proposed for the rapid assessment of newborns; Apgar scores indicate the presence of several vital signs and an assessment of their severity.

There are five signs in total, and they can be scored from 0 to 2 points. 0 points – the sign is absent, 1 point – weakly expressed, 2 points – clearly expressed. Apgar scores are summed up to form a number from 0 to 10; however, an ideal 10 score in the first minute of life is almost never found.

Apgar assessment of newborns has quickly gained popularity around the world due to its practicality, accuracy in assessing the condition of newborns, and the absence of the need to use any equipment. It is carried out by an obstetrician who attended or was present at the birth by a neonatologist.

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

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

How to interpret an Apgar score:

- 7-10 points – the child was born healthy and adapted perfectly.
- 5-6 points – there are slight deviations in 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, without resuscitation measures the child will die.

Below is the Apgar table used for evaluation.

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

Often, the Apgar score also helps pediatricians who later monitor the baby to monitor a specific aspect of his condition.

The article below contains information about the essence of this technique, as well as how exactly each aspect of a newborn’s life is assessed by specialists. The Apgar score (newborns are assessed within a minute after birth) is considered the fastest comprehensive system for determining the need for resuscitation procedures in each specific case

This need is due to the instability of the health status of newborns, requiring careful monitoring during the first minutes of the child’s life. The essence of the methodology is to evaluate the main criteria (1 or 2 points) and further summarize the results obtained.

The following are examined by obstetricians and neonatologists:

• skin, in particular its color;
• quality and quantity of heart contractions, capable of recording significant deviations in the functioning of the cardiovascular system little man;
• the presence of reflexes, as well as their “lively”;
• 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 his ability to independently fill his lungs with air and exhale it without retaining it in the body for a long time.

If there are 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 over time. In such a case, the child, as a rule, is sent to his mother not earlier than the second days after birth.

Indicators of the normal condition of a newborn in the table

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

Thus, an absolutely healthy baby, ready to begin independent life, is usually “awarded” 9-10 Apgar points (2 points for each criterion). The most common score lately is 8-9, which is most often due to decreased tone of the limbs in modern children being born.

Indicators of the normal condition of a newborn are as follows:

Criterion/Apgar score	Apgar score 0	Apgar score 1	Apgar score 2
Uniformity and saturation of skin color	White or blue skin color throughout the body	Pink or red color of the skin of the entire body, with the exception of the extremities (usually have a bluish tint)	Pink or red skin color throughout the body, including the arms and legs
Work of the cardiovascular system (heart rate)	No heartbeat	Less than 100 per minute.	More than 100 per minute.
Presence and “aliveness” of reflexes	Complete lack of reaction	Weak reflexes	Active reflexes in the form of loud screaming, crying, sneezing, etc.
Muscle tone	Complete absence of minimal tension in the limbs (legs and arms hang sluggishly)	Slight tension, expressed as occasional slight flexion of the legs or arms	Active change in the position of arms and legs, “hardness” of the back muscles
Respiratory system maturity	Lack of breathing	Irregular breathing, no or quiet cry at birth	Easily audible breathing, loud cry, crying at birth

Decoding indicators: what deviations from norms indicate

The Apgar scale, in particular the result of using this system, can help parents of a newborn 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) is traditionally “awarded” to babies who immediately begin to voice after birth, as well as to those whose total number of inhalations and exhalations in one minute will be stable, amounting to at least 40-45 pulmonary contractions.

If there is no or minimal intermittent cry in the child after birth, doctors give 1 point and observe the newborn during the first day of life.

If there is no activity from the respiratory system, neonatologists and obstetricians will immediately put the baby on a system for artificial ventilation 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 underdevelopment of the system itself (in the case of premature birth), and about disruptions in its functioning, most often due to “difficult” prolonged labor, usually leading to fetal hypoxia (the 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 suffered during the birth process. Children whose heart beats more than 100 times per minute usually deserve 2 points. The baby's heartbeat is less than 100 times per minute. usually observed during premature birth.

Such a deviation from the norm indicates that the child’s body is not ready to function separately from the mother’s vital activity systems. In the case of full-term delivery, such disturbances in the cardiovascular system may be a consequence of prolonged fetal hypoxia during the birth process.

If there is no heartbeat in the newborn in the first seconds of life, doctors will attempt to resuscitate him. The reason for this could be a medical error; prolonged and traumatic childbirth, as well as infectious diseases of the mother, which provoked significant disturbances in the functioning 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, positive side the child will attempt to straighten his body, thereby bringing it to a natural position.

The basis for a less satisfactory result in the child’s Apgar rating system (1 point) will be his reluctance to move. In such children, as a rule, the arms and legs are in a bent or, on the contrary, “hanging” position, very for a long time

after birth.

A “lazy” change in body position, extension of the body, is also considered a variant of deviation, as is prolonged preservation of the fetal position or the “lifeless” hanging of the child in the arms of an obstetrician or neonatologist.

The reasons for deviations in the normal state of muscle tone of the baby may be the consequences of a difficult birth or birth trauma, damage to nerve endings, as well as improper formation of the muscle corset while in the womb. Provided that all other assessment criteria on the Apgar scale have a high score, unnecessary muscle tone

or, conversely, muscular dystonia is corrected by physiotherapeutic procedures, drug treatment, as well as several courses of massage, in accordance with the recommendations of a pediatrician and neurologist.

Reflexes

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

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

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 uniform pink skin of the whole body. If there is a blue tint on the limbs, observed against the general background of the normal color of the skin surface of the newborn, doctors will check the baby for possible injuries to blood vessels and nerve connections that disrupt normal blood circulation in the child’s body.

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

A caesarean section allows the baby to avoid passing through the mother's birth canal, which is often the most traumatic stage of childbirth. Such features of the color color of the baby’s skin during natural childbirth indicate that he is suffering from a lack of oxygen at the time of his “protracted” birth.

Algorithm for examining a child at birth

The Apgar scale (newborns are assessed exclusively by specialists with its help) implies a certain algorithm for organizing the examination. Having received the baby from the “uterine” environment, the obstetrician or neonatologist makes an immediate assessment of the condition of his skin.

Having looked at the child’s body and made sure of its uniform normal color, the specialist analyzes the presence of a cry in the baby.

Then, having determined that the child’s condition does not cause concern, he 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 nipple latching does 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 specified activities, neonatologists evaluate the baby’s muscle tone based on his motor activity while moving around the maternity unit in the hands of a specialist.

Apgar system indicators are re-evaluated at 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 to further examine the baby every 5 minutes. over the next 20 minutes..

How are points calculated?

Having given a certain number of points indicating an ideal (2 points), satisfactory (1 point) or unsatisfactory (0 points) state of health of the newborn for each of the 5 basic criteria, doctors add up 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 period and method of birth) gives parents a clear idea of ​​​​the current state of their child.

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

They can be triggered by a difficult course of labor (the threat to life usually disappears a few hours after the birth of the baby), chronic diseases newborn (occur when the mother fails to comply healthy image life during pregnancy or the transmission of infectious diseases), as well as the general immaturity of the systems child's body(premature birth).

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

What does 4-7 points mean?

An Apgar score of 4-7 points is, although low, acceptable. A child who receives such an assessment usually has moderate or mild health problems that are usually treatable with medication.

Despite a number of dysfunctions that require correction, in the vast majority of cases there are no consequences from this condition of the baby at birth in his future life.

What does 8-10 points mean?

8-10 points, obtained as a result of summing up the indicators for all basic criteria, which 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 observation 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, which seems objective at first glance, is given by one specific specialist and cannot be considered the “ultimate truth.”

The figure shows the interpretation 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 to her own child, is able to radically correct the situation.

The medical staff of maternity hospitals are sufficiently equipped to monitor and positively influence the abnormalities in the child’s condition at birth. When releasing the mother and newborn from the institution after childbirth, doctors will make appropriate forecasts for the further development and health of the baby, and also give recommendations to parents in each specific case.

Apgar scale in examples

To form a detailed idea about the condition of the newborn, It is advisable for parents to familiarize themselves with examples of Apgar scores and their interpretations:

• 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 – with such assessments, the baby’s health 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 has general weakness and exhaustion of the body as a whole, which necessitates the need for doctors to monitor its condition during the first days after birth;
• 8/9, 9/9, 9/10, 10/10 – indicators characteristic of absolutely healthy children who do not require specific care and supervision from medical personnel.

The Apgar score, 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.

By carefully studying the above information, parents will be able to understand how experts assess the child’s health using this system, as well as whether they should worry about the number of Apgar scores announced by doctors.

Useful videos about the Apgar score and how to interpret the score

What is the Apgar score:

How is the assessment carried out:

The Apgar score for newborns is a system for the first assessment of newborn health born child. Doctors carry out such an assessment in the first minutes of life. The first Apgar score is obtained in the first minute after birth. The second rating is given after 5 minutes. As a result, the Apgar score consists of two numbers that are assigned by the doctor when examining the newborn.

The Apgar score allows the doctor to determine whether special treatment is needed health care newborn. But besides the doctor, it is also important for the mother to know everything about the health status of her child. In this article we will tell you how to decipher the Apgar scale, what scale scores mean for newborns.

The system for assessing the condition of a newborn is a table in which five main criteria of health status are entered, each rated from 0 to 2 points. The Apgar score can range from 0 to 10 points. Let's look at the main criteria of the Apgar score.

The main criteria for the condition and functioning of the child’s body, according to which points are awarded:

1. Heart work (HR)) – 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 takes 40-45 breaths per minute, accompanied by a piercing cry. If breathing is irregular and slow, high scores (9.10 points) are not given.
3. Muscle tone– assessed by the intensity of motor activity of the newborn. The more actively a newborn wiggles its legs and arms, the higher the Apgar score.
4. Reflexes of a newborn– the presence of unconditioned reflexes in a newborn is assessed (sucking, swallowing, grasping, etc.). But the main reflexes are screaming and breathing. If a child screams loudly, sneezes, and clears his throat, that’s good! If the baby clings to the mother's breast and the fingers are tightly clenched into fists, this is also very good! There are other unconditioned reflexes that are assessed by the doctor (read more HERE)
5. Color of the skin– the child’s skin color is assessed, Special attention palms, soles, lips and oral mucosa. If the skin color is pink (from light to reddish) it is scored 2 points, if the skin is bluish - 1, if the skin is pale with a bluish tint - 0.

Each criterion is evaluated and the points are summed up.

Apgar scores

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

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

Interpretation of Apgar scores

As we have already written, the child’s condition is assessed using the Apgar scale twice: in 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 become somewhat accustomed and adapted to his new conditions.

Apgar score 0

If the child was given a score of 0, then the child was stillborn.

1 point, 2 points on the Apgar scale

With a score of 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 as three points after 5 minutes, is a critical condition. The baby requires resuscitation or other urgent medical care

4 points on the Apgar scale

If a child was given a score of 4 at birth, then the child’s condition is regarded as serious. The newborn requires constant monitoring by doctors.

Apgar score 5

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 examination situation.

Apgar score 6

With scores of 6 and 7 points, doctors conduct additional control examinations every 5 minutes for 20 minutes and monitor the dynamics of changes. In this condition, the child may need help at any time (i.e., examinations are carried out at the 5th, 10th, 15th, 20th minute of the child’s life).

Apgar score 7

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

8 points on the Apgar scale

If the child is 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!

Apgar score 10

An Apgar score of 10 at 1 minute is extremely rare. Ten Apgar scores at the fifth minute indicate that the child’s health is ideal!

10/10 points - does not occur in practice.

Newborn Assessment Chart

Apgar results

According to the table, we can conclude: if a child was given 7, 8, 9, 10 points on the Apgar scale in the first minute of birth, and 8, 9, 10 points in the fifth minute, then this is good. If the indicators are 7/8, 8/8, 8/9, 9/9, 9/10 or 10/10 points, there is no need to worry, your health is in perfect order.

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

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

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

When assessing less than 5 points the condition is assessed as severe, hypoxia occurs. Most often, the newborn requires resuscitation. Such children are transferred to a hospital and not discharged until their condition improves. up to 7 points according to the Apgar scale.

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

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

Every modern mother in labor knows that when recording the parameters of a born child, weight, height and the newborn’s Apgar score are used.

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

An anesthesiologist from America, Virginia Apgar, has developed a special table to help her resuscitation students, which allows them to clearly determine the condition and viability of the baby in the first minutes of a child’s birth.

The purpose of the scale is to quickly assess the condition of a newborn child regarding the need for resuscitation measures.

What indicators are assessed?

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

• Coloring of the skin of the body and 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 - Moves actively, coughs, sneezes, screams.

• Muscle tone.

0 - Absent, limbs hanging down.
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 - Not breathing.
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 child's condition is assessed using the Apgar scale in the 1st minute after the birth of the fetus. The second point is the same parameters assessed at the 5th minute.

Sometimes, with very low indicators, doctors give a third estimate at the 10th minute of the newborn’s independent life. Parents are usually given a double score, for example 7/9.

A score of 3 or less on the scale indicates an unfavorable condition of the child and the need for special life support measures.

7 points and above – the child is normal, viable, has good chances gradually adapt to independent life.

Decoding the Apgar scale

Assessing the condition of the newborn helps doctors, if necessary, quickly take measures to support the child’s life:

• From 0 to 2 points.

The child's viability is at risk. Immediate resuscitation measures are required.

When timely professional assistance is provided, the baby shows best result Apgar 5 and 10 minutes after birth.

Subsequently, the baby will need more careful care and monitoring. However, it is believed that even “B” students are capable of becoming physically strong and smart children in the future.

This is how premature babies are usually assessed. If the condition does not improve in the 5th minute, 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 baby will need close medical supervision in 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 a stay in intensive care is not required.

Optimized assessment of child viability. The baby tolerated the birth well and is not at risk. Doctors only make sure that the process of feeding and weight gain improves.

If the mother has enough milk and the baby is gaining weight, then his condition is not in danger.

• 10 points.

Highest Apgar score. During natural childbirth, the child rarely receives the highest score in all respects.

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

It is believed that “caesareans”, under equal pregnancy conditions, may have a higher Apgar score, 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 Virginia Apgar's surname as an abbreviation to better memorize the table of Apgar scores.

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

1. A ppearance – appearance.
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 also exist among specialists in the German and Spanish language environment.

In American English, a neologism has appeared that deciphers the abbreviation APGAR - American Pediatric Gross Assessment Record (General American Pediatric Gross Assessment Record). We are, of course, talking about the newborn assessment system, famous among obstetrics all over the world.

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

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

Why doesn’t a healthy baby with an easy birth get an Apgar score of 10?

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

1. In order for the baby’s circulatory system to fully function on its own, it takes about 5 minutes. Until this time has elapsed, the arms and legs may retain a bluish coloration.
2. There are cases when a healthy baby receives 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 kind of test for the physiological criteria of the baby’s viability.

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

In the first year of life, scores at birth of a child of 8/8 or other possible combinations of scores will be of interest to the pediatrician, pediatric neurologist and other highly specialized children's doctors.

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