Immediately after the birth of a newborngets his first rating - on the Apgar scale. It is formed on the basis of a study of important indicators of the child by the specialists - respiration, skin color, heart rate, muscle tone and reflexes of the newborn. From the results of this study will depend on the further actions of medical professionals. And it is the assessment of the newborn on the Apgar scale that will allow to determine what the care for a child who was born should be and whether he needs additional conditions. In addition, this study may indicate to specialists the probability of the presence of any pathology immediately after delivery.
What does the Apgar scale mean?
This study was suggested by the Americananesthesiologist Virginia Apgar in the middle of the last century, namely in 1952. His initial task was to help the nursing staff to determine which babies needed special care by assessing vital signs of the newborn.
This study also helps to find outhow difficult was the process of childbirth for the child, how he influenced him. At each of the main indicators may affect heavy childbirth. For example, during delivery, a child may experience hypoxia, that is, a lack of oxygen as a result of being pulled by special forceps or he has been passing through the birth canal. As a result, the skin may change, which will subsequently affect the assessment of specialists on this scale.
Purpose
Из вышесказанного следует, что данное research in extremely rare cases may indicate the possibility of the occurrence or presence of any pathology and pathological condition in a newborn child. In all other situations, the assessment of the main indicators of the baby, born, is necessary to understand how the birth affected the physical condition of the child and what the child’s condition is right after the completion of the delivery process.
Стоит понимать, что в большинстве случаев данное research is subjective. The final assessment can be influenced by many factors, the fundamental of which is the severity of the process of childbirth.
A child with average points may have better health than a child who received the highest scores as a result of the study.
How to measure
The scale proposed by the American physicianincludes five indicators, the measurement of which occurs on the first and fifth minutes of a newborn's life. Each criterion is rated from 0 to 2 points. Accordingly, the higher the rate, the better the condition of the child at the time of birth. If the result of the study is less than 7 points, experts continue to monitor the condition of the baby at 10 and 15 minutes of life.
Если в результате исследования состояние по шкале Apgar is rated with low scores, experts decide whether to transfer the newborn to a special department for placement in a special box and to provide additional medical care.
If the child received at birthlow scores, a specialist medical institution conducts resuscitation actions, so that the indicator obtained as a result of a secondary study, a significant increase.
Indicators of the newborn
A total of five fundamental indicators of the state of a newborn baby are examined:
- the color of the baby's skin;
- heart rate, i.e. pulse (HR);
- irritant response;
- muscle tone and reflexes;
- newborn breathing.
Each criterion is rated from 0 to 2 points, andApgar scale itself is presented in the form of a table. When summing up all five indicators, medical institutions get a final result, which allows you to assess the condition of the baby in the first minutes of life and to understand how well the child adapts to the outside world.
Respiratory assessment
Normally a newborn baby commits from 40 to45 respiratory movements per minute. This indicator is estimated by experts at two points. In addition, the baby cries out, which also speaks of the normal functioning of the lungs and also affects the result of the study. The doctor gives one point if the newborn cries, but does not scream, the voice trembles, and breathing is slow. If breathing and sounds are absent, the specialist puts a zero point based on the study.
Heart rate assessment
The heart of a newborn baby beats very quickly.The process of childbirth for both mother and baby is very stressful, which is why the baby needs time to adapt to environmental conditions. Normally, the heart rate of a baby born into a world ranges from 130 to 140 beats per minute. With these indicators, the work of the heart of the newborn is estimated at two points. A specialist of a medical institution puts 1 point in the case if the newborn breathes slowly enough and his heart rate is low. This phenomenon can occur if the child has a shortage of oxygen in the womb or the oxygen supply to the body of the baby has been disrupted amid heavy delivery processes.
In the absence of a pulse, the child’s heart is rated at 0 points.
Assessment of muscle tone and reflexes
It is known that in the womb of the child tothe completion of pregnancy does not have enough space, and the position of the child becomes monotonous. That is why the freedom of action acquired by a newborn leads to the fact that the first movements of a baby born to a child have a chaotic, erratic character. This is the norm. In this case, the doctor assesses the indicator of muscle tone in two points.
If a newborn baby holds top andlower limbs in a bent position and makes movements only occasionally, a specialist puts 1 point on the results of a study of the state of muscle tone of the baby. If there are no movements, the doctor puts 0 points.
In addition, the doctor assesses the presence of majorunconditioned reflexes of the child immediately after birth and their proper functioning. The presence of such is characterized by a scream and the first independent sigh. A medical professional monitors the reaction of the newborn to the stimulus.
In the absence of unconditional reflexesExperts estimate this figure at zero points. If outside expression was used for their expression, the doctor puts one point on the results of the study of the reflexes of the newborn. The baby receives the highest score if the unconditioned reflexes are manifested without assistance.
How to evaluate skin color
Normally, the skin of a newborn has colorfrom pale pink to bright pink. It is this skin tone that indicates normal blood circulation in the baby’s body. In addition, the specialist gives an assessment of the color of the mucous membranes of the child, lips, palms and soles of the tiny legs of the crumbs. If the baby's skin color is pink without additional shades, this indicator is estimated at two points. A child gets one point if his skin has a bluish tint. If that shade has the entire body of a newborn baby completely or it is evenly white, the specialist places zero points.
При рождении цвет кожных покровов крохи может have a bluish tint. After medical manipulations by a specialist, the baby’s skin loses this feature. That is why the score obtained as a result of a secondary study, most often higher than the initial.
If the baby’s skin has a blue tint for a long time, this should alert the specialist and be a signal for additional research.
Points on a scale
Оптимальное состояние новорожденного оценивается in 7-10 points. A child's Apgar score of 5-6 points indicates the presence of slight deviations in the condition of the baby. 3-4 points characterize the average deviations in the somatic state of the crumbs. And, finally, 0-2 points signal that the child’s condition is far from normal, and he needs constant supervision by specialists.
Decoding the Apgar scale
To understand the results of the study, it is necessaryfind out what Apgar scores mean. Evaluation of the fundamental indicators of the state of the newborn occurs twice: in the first and fifth minutes of life. That is why the second result may differ slightly from the original score. For example, at birth, the baby received 7 points, and after 5 minutes his condition was estimated at 8 points on the Apgar scale. It is worth noting that the difference between the indicators may differ not by one, but by several units, and may not change at all.
For example, at birth, the child’s conditionrequired medical supervision as a result of heavy labor (or under other conditions) and was estimated at 6 on the Apgar scale, and after 5 minutes the newborn adapted somewhat, and the initial rate increased to 8.
It should be understood that the data obtained inthe result of the examination of the newborn is not an assessment of the overall health of the child and in no way signals the mental pathologies of the baby. This study assesses the condition of the child at the time of birth and allows you to understand how well the newborn has had the birth.
The maximum score, 10 points, newborns are extremely rare. The most common results are 7-8 points.
What factors can affect points
The result of the study can affect severethe process of delivery, as a result of which the child was observed asphyxia. In addition, the cause of low rates can be hypoxia, which, in turn, can be chronic and acute. Chronic hypoxia accompanies the child throughout the entire period of pregnancy, it occurs due to malformations or pathologies of pregnancy. Acute form occurs in the process of delivery.
Кроме того, низкая оценка по шкале Апгар может to be associated with many other factors - injuries and infections. For example, a mild form of brain damage in a newborn baby, a syndrome of increased neuro-reflex excitability, is estimated at 7 points.
Instead of concluding
Investigation of the state of a newborn baby,conducted in the first few minutes after his birth, allows the doctor to understand the need for additional medical care for a child who has just been born, and gives the possibility of a quick response in case of unforeseen situations.
It should be noted that Apgar scores do notcharacterizes the overall health of the baby. Why then do we need these indicators? Apgar score can only predict the occurrence of various pathologies. But it is not a guarantee of such appearance.
The low rate obtained as a result of research crumbs, should not lead mom to panic. Many factors can affect the outcome, including the nature of the flow of labor.
Do not be upset if the baby receivedlow scores from the study. Indeed, in most cases it is subjective. Even the most healthy baby can not get the highest scores only for the reason that his limbs turned a little blue during childbirth or he cried out loudly.
Alert should scores below 5-6 points. In other cases, the state of the newborn baby is not in danger.
