Apgar Scale – how is the assessment done?newborns? How does Apgar score affect future health?child

Пн, 28 ноя 2016 Автор: врач-терапевт Елена
Kornilov

The Apgar scale is a quick definition of condition.
life activities of newborns to decide on
urgent events.

The total points are calculated according to certain criteria.
(there are five of them), and the viability is determined by the results of the calculation.
child на первой и пятой минутах после рождения. Each item
Apgar scores are rated from 0 to 2 points, the amount when calculating
ranges from 0 to 10. This is one of three options (except
compulsory height and weight), reported by parents, although
For them, the Apgar scale is uninformative.

It is designed for immediate response by neonatologists in case
life threatening conditions and the need to use
special resuscitation equipment. Earlier evaluate
the newborn was trusted by the nurses, now it is the duty of the doctor.
Now with its help determine the degree of hypoxia
родившегося child.

Apgar scores – Apgar scores for newborns

Разработчик метода — Вирджиния Apgar, врач –
an anesthesiologist who first published it in 1952 on
regular annual congress of anesthesiologists. Now this estimated
The scale is used in obstetric institutions around the world. By
According to experts, this is the most accurate way to determine the state
vitality of the body of newborns today.

Apgar Scale – Apgar score for newborns –
includes 5 criteria:

1. Leather.

2. Heart.

3. Congenital reflexes.

4. Muscles.

5. Breathing.

More specifically, the criteria go in that order and by initial
Letters generally name the developer:

Appearance – skin color.

Рuls – heart activity.

Grimace – mimicry.

Activity – muscle tone.

Respiration – breath.

Each of the five items presented, as mentioned,
ranked from 0 to 2:

0 points – no sign;

1 point – weak expression;

2 points – normal variant: bright manifestation.

The purpose of assessing newborns on the Apgar scale

Apgar Scale – Apgar score for newborns –
used immediately after birth to resolve the issue of
application of urgent measures:

– mechanical ventilation (artificial respiration);

– placement in a special box;

– blood transfusion.

The condition is assessed immediately after the child
was born to start rendering
urgent activities, since by the end of the first minute help can
to be already useless.

The main indicators of the Apgar scale – assessment of newborns on a scale
Apgar

The physiological maturity of the body is characterized by
following key indicators:

1. Skin color:

0 points: sharp pallor or general cyanosis (cyanosis).

1 point: normal skin color of the whole body, but –
cyanotic limbs.

2 points: normal coloring of the skin of the body and limbs.

The skin of the newborn is normal pink hue, most often such
color in newborns as a result of cesarean flow, since
extraction is not at risk of hypoxia due to the fact that
bypasses the birth canal.

2. Pulse:

0 points: pulse is not determined,

1 point: less than 100 beats / min.

2 points: more than 100 beats / min.

Normally, a heart rate of about 100 beats per minute.

3. Reflexes:

0 points: no congenital reflexes.

1 point: slight movement or grimace, weak moan instead
cry (weak reaction).

2 points: from the first seconds of birth – a loud cry, active
movement, coughing, sneezing.

В норме рефлексы у здорового child — громкий крик, попытка
push off from the heel of your palm and crawl, trying
идти, если child опереть ножками о стол, выразительная
facial expressions.

4. Muscle tone:

0 баллов: тонус отсутствует, ручки и ножки child свисают.

1 point: the tone is reduced, the limbs are slightly bent.

2 points: active movements are expressed.

Muscle tone at birth is considered normal when a child
is in a grouped position, resembling a pose in the womb
mothers: with limbs pressed to the body – 2 points. If at
trying to bend the arms and legs there is a weak resistance –
это 1 балл по шкале Apgar.

5. Breathing:

0 points: no breath.

1 point: irregular intermittent breathing.

2 points: normal calm breathing.

The frequency of respiratory movements (NPV) is normal in the newborn
is about 45 movements per minute. This is 2 points on the scale.
Apgar. If the NPV is less than 45 / min, hoarse, uneven, the child is given
oxygen through a special installation of oxygen supply. If breathing
absent, the newborn is urgently connected to the ventilator.

Как трактуется оценка новорождённых по шкале Apgar

By статистике максимальное количество баллов –
10
– при оценке новорождённых по шкале Apgar наблюдается
only 10 – 15% of cases. 10 points is an ideal indicator on
момент рождения child. In our country, such an assessment –
extremely rare, the reason is in the mentality and system
health care (dozens of clinics abroad put
often).

Score is not a reflection of health or mental
развития и диагноза child. This is a reason for quick response to
неотложное состояние child. This result also does not affect
on further life and development, of course, if he is not
close to zero or zero. Шкала Apgar отражает объективные показатели
vitality after birth in the first and fifth minutes of life.
This is a kind of diagnostic express method.

Оценка новорождённых в большинстве случаев составляет 7
– 8 or 8 – 9 points.
The second digit is the estimate
which is held in the fifth minute after birth. At discharge
both results of the evaluation of the newborn are indicated: the first one
определяется в момент появления child и подразумевает, как
the child suffered childbirth, and the second, in dynamics, after five minutes,
denoting how the adaptation of the newborn to
environment outside the womb. Usually it is higher than the first. But
sometimes the assessment of newborns does not change even in the fifth minute of life:
7 – 7.

• Оценка новорождённых по шкале Apgar в 7 – 10 баллов
observed in healthy children.

• Низкая (3 – 6 баллов) оценка указывает на
acute lack of oxygen in the blood of the fetus, which has arisen due to
hypoxia in the womb.

Causes of hypoxia:

– pathology in a pregnant woman;

– disorders of intrauterine development.

5 – 6 баллов означает лёгкую степень
lack of oxygen.

3 – 4 балла — гипоксия средней степени
severity, in these cases, urgent resuscitation care is needed
to prevent further deterioration or save lives.

0 – 2 балла — тяжёлая асфиксия (удушье).

If at the 5th minute the score still does not get 7
points, the observation continues until it reaches 7 points.
As a rule, possible changes are recorded during the first 20
minutes of life.

If the child scored 6 points, he must be transferred from
hospital in the hospital. Extract occurs after the condition
will improve. After a certain time, even with a low
assessment, impaired function of the nervous system are restored.

Seizures and coma – severe pathology of the central nervous system, condition according to
шкалы Apgar составляет 0 – 4 балла.

In addition to various health disorders in pregnant women,
the development of hypoxia in the fetus can lead to:

– Smoking and drinking alcohol during pregnancy;

– poor nutrition;

– failure to comply with the recommendations of the doctor during pregnancy;

– injuries or infections.

Шкала Apgar и прогноз в будущем

All clinical symptoms of neurological abnormalities in
newborn are united under the common name – perinatal
encephalopathy (PEP). There are several variants of AED depending
from the prevailing symptoms.

You need to know that a low score does not necessarily result in
further to negative results. If in the fifth minute
child прибавляется баллы, или результат достигает 6 баллов —
maybe in the future everything will come back to normal. Result less than 6 points, in
mostly have premature babies. Many newborns with
at birth, various forms of perinatal encephalopathy (including and
moderate), all impaired function of the nervous system
over time, they are fully restored. Для будущей жизни child
показатели шкалы Apgar не имеют никакого смысла. This is subjective.
assessment of the state of organs and systems at the moment, when
происходит определение жизнедеятельности организма child.
Compare the health or developmental prospects of two children with different
estimates do not make sense. Even if the score was 0 – 2
балла
, это не означает, что ребёнок останется больным и
incapable. Often these children catch up and even further
are ahead in their development of peers with higher
indicators. В дальнейшем здоровье child зависит от внимания и
parental care, proper and rigorous implementation of all
doctor’s advice.

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