Scale newborn Apgar in the table. Normal, that is 4, 5, 6, 7, 8, 9, 10 points. Evaluation of the child's condition at birth

Apgar score for the assessment of the newborn, allows health workers maternity hospital to determine whether required only been born a child of their help.

Often Apgar score helps pediatricians, after watching the baby, monitoring a specific aspect of his condition. The following article contains information about the essence of this technique, as well as how it assessed each of the parties newborn specialists life.

What is it, the essence of technique

Apgar score (neonates with it evaluated one minute after birth) is considered the most fast integrated system for determining the need for resuscitation procedures in each case. Traditionally it consists of 2, at least 3, "measurements" baseline vital baby (1 min., 5 min., At least 10 minutes. after birth).

This need is due to the instability of the state of health of newborns requiring close monitoring during the first minutes of life. The technique is to assess the basic criteria (1 or 2 points), and further summation of the results.

Research by obstetricians and neonatologists are subjected to:

• the skin, in particular its color;
• quality and number of heart rate that can capture significant deviations in the functioning of the cardiovascular system of the little man;
• the presence of reflexes, as well as their "liveliness";
• the tone of the muscular system of the body baby, of particular importance is the activity of the limbs;
• respiratory system toddler, namely its ability to independently fill your lungs with air and exhale it without delaying in the body for a long time.

If there are significant deviations in the operation of the above systems and organs of the child (Apgar score of less than 5) medical experts, in most cases, take the decision to close monitoring of the state of the baby dynamics. In such a case, the child is usually sent no earlier than the second day after the birth of the mother.

Indicators of the normal state of the newborn in the table

Apgar (infants by this method have begun to evaluate in 1954) illustrates how just been born baby is ready for life outside the womb.

So, it is absolutely healthy baby, is preparing to launch an independent life activity, as a rule, "awarded" 9-10 Apgar (2 points for each criterion). The most frequently encountered in recent score 8-9, which most often develops due to low tone of limbs in children being born today.

normal state newborn indicators are as follows:

Criterion / Score Apgar	0 points of Apgar	1 point Apgar	2 points on the Apgar
The regularity and richness of the skin color	White or blue color of the skin of the whole body	Pink or red color of the skin of the whole body, except for the extremities (usually have a bluish tint)	Pink or red color of the skin of the whole body, including the arms and legs
Cardio - vascular system (heart rate)	The absence of heartbeat	Less than 100 m.	More than 100 per minute.
The presence and "liveliness" reflexes	Complete absence of reaction	mild reflexes	Active reflexes a loud cry, crying, sneezing, etc.
The tone of the muscular system	The complete absence of undervoltage in the extremities (arms and legs languidly "hang")	A small voltage, which is expressed in a rare light curls legs or arms	The active change of position of hands and feet, "hardness" of the back muscles
The maturity of the respiratory system	not breathing	Shortness of breath, lack of or a quiet cry at birth	It is easy to listen to your breath, a loud cry, cry at birth

Decoding performance: as indicated by the deviation from the norm

Apgar, in particular the use of this system can help the parents of an infant to form an idea of ​​the "fortress" the health of their baby.

Determine which of the evaluation criteria, according to the neonatologists and obstetricians, did not deserve the highest number of points, mom and dad may suggest the presence of possible deviations in the general condition of the child, as well as, in some cases, causes happened.

Breath

The maturity of the lungs, which is expressed in a newborn's ability to start their own inhale air after cutting the umbilical cord indicates the normal development of the respiratory system.

The maximum score on the Apgar (2 points), traditionally, "award" kids, instant after the birth of the votes castAnd those whose total number of breaths per minute will be stable in its integral number not less than 40-45 pulmonary contractions.

In the absence of or minimal discontinuous crying child after birth, doctors give 1 point and watch the newborn during the first days of life.

If there is no activity on the part of the respiratory system, neonatologists and obstetricians immediately put crumbs system ventilator and conduct the necessary resuscitation procedures in an attempt to return to the little man life.

Insufficient respiration rate, as well as its complete absence, can testify to the underdevelopment of the system (in the case of premature birth), and of violation in its functioning, often because of "hard" prolonged labor, usually leading to fetal hypoxia (the child in the birth canal is suffering from a lack of oxygen).

Heart rate

By the number of heart beats medical staff maternity hospital determines how the baby suffered during birth. 2 points usually deserve children, whose hearts beat more than 100 times per minute. Heartbeat baby in an amount less than 100 times a minute. usually observed in preterm labor.

Such a deviation from the norm indicates the child's body's not ready to operate separately from the mother's life support systems. In case of delivery on time, similar violations in the cardiovascular system may be a consequence of prolonged fetal hypoxia during birth.

In the absence of heart beat in the newborn in the first seconds of life, physicians it will attempt resuscitation. The reason for this may be as a medical error; lengthy and traumatic childbirth, and infectious diseases of mother, provoked substantial disruptions to the cardiovascular system of the child.

muscle tone

In the case of an ideal infant health, the strength of his muscular corset will be reflected in the physical activity. In the absence of violations of the baby will be randomly and quickly change the position of the upper and lower limbs, dynamic flexing them. Moreover, the positive side of the child will attempt to straighten his body, bringing it thereby in a natural position.

The basis for the less than satisfactory results in the child's evaluation system for the Apgar score (1 point) would be his unwillingness to move. These children tend to be the hands and feet are flexed or vice versa "hanging" position for a long time after birth.

"Lazy" change of body position, extension of the body, are also considered for this deflection as prolonged preservation of fetal position or "lifeless" baby dangling in the hands of a midwife or neonatologist.

The reasons for the deviation in a normal state of muscle tone grudnichka consequences can be a difficult birth or birth injury, nerve damage, as well as muscular corset malformation at the time of being in utero mother.

Provided that all other evaluation criteria Apgar have a high score, excessive muscle tone or, conversely, muscle dystonia adjusted physiotherapy, medication, as well as the passage of several massage courses, in line with the recommendations of the pediatrician and neurologist.

reflexes

The presence of reflexes needed to separate existence, determined by their newborn to stimulate children's specialists, examines the child after birth. The maximum score on the Apgar "honored" usually infants who independently demonstrates a natural tendency to suck hard enough, ingest, inhale and exhale air.

In the absence of visible manifestations of Obstetricians reflex or Neonatologists:

• best approximate a finger to his lips, baby, causing it to suck;
• vertically placing the child which, during normal development should occur reflex "walk";
• is inserted into the nose newborn catheter to remove the mucus from the nose residues and other "products" generic activities, encouraging small person sneeze or at least try to look away or to show displeasure happening;
• a grudnichka on a solid surface, turning over on his stomach and put his hands to the soles of the feet of the child, waiting for crawling reflex manifestations carried out by the repulsion from the support.

The absence of reflexes in any manifestation indicative of immaturity or significant injury of the nervous and muscular system of the person who had just been born.

Color of the skin

Ideally, the child should fall into the hands of obstetricians and neonatologists with a uniformly pink color of the skin of the whole body. In the presence of a blue tint to the extremities, which is observed on the background of the normal color of the skin surface of the newborn, doctors check your baby for possible injuries of blood vessels and nerve connections that disrupt the normal circulation of blood in the child's body.

When excessive pallor and, in some cases, the blue color of all baby's body, neonatologists immediately take over the resuscitation procedure to restore blood flow. Deviations from the norm in this case is most often observed in children who were born naturally.

Caesarean section to avoid babies pass through the birth mother's ways, is often the most traumatic stage of labor. Similar features color the baby's skin color with natural childbirth evidence of his suffering from a lack of oxygen at the time of "protracted" birth.

Algorithm of examination of a child at birth

Apgar (newborns with the help of experts evaluated exclusively) means specific algorithm surveys the organization. Adopting a baby from the "uterine" environment, an obstetrician or neonatologist produces an instant assessment of the condition of his skin.

Looking around the child's body, making it uniform normal coloration, a specialist analyzes the presence crying in infants. Giving an initial inspection of not more than 30 seconds, the pro measures the heart rate, and the amount and uniformity of breaths, using special medical equipment.

Then, having determined that the child is not a concern, it is applied (if possible) to the mother's breast. This method allows the physician to assess the presence of the natural reflexes, in particular, to sucking. If the seizure of the teat has not occurred, the child artificially trying to "provoke" in the demonstration of their own reflections in the above methods of paper.

In parallel with the above actions, neonatology estimated muscle tone of the child, in terms of its physical activity during movement of the block on maternity expert hands.

Re-evaluation indicators Apgar system is made in the fifth minute of life grudnichka. If the total score after the second survey will be less than 7, the doctors usually decides on doobsledovanii baby every 5 minutes. over the next 20 minutes ..

How to account for points?

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

What does 1-3 points?

Apgar score (neonates with it is examined time depends on the process and the birth) makes clear to the parents an idea of ​​the condition at the moment is their child.

Assessment 1-3 score is considered low, and strong evidence of abnormalities in the baby's health.

They can be provoked by severe labor (threat to life usually disappears after a few hours after the birth of the baby), a chronic disease of the newborn (there non-compliance with the mother of a healthy lifestyle during pregnancy or postpone it infectious diseases), as well as the general immaturity of the child's body systems (premature childbirth).

It is worth noting that in some cases a low Apgar score necessitates emergency measures and the transfer of the little man in the intensive care unit.

What does it mean 4-7 points?

Result Apgar equal score is 4-7, though low, but acceptable. The child gets such an assessment is usually a deviation or moderate severity health generally amenable to drug treatment.

Despite a number of dysfunctions that require adjustments, the effects of this condition the baby at birth, in his next life, in most cases, is not observed.

Which means 8-10?

8-10 obtained by adding up the scores of all the basic criteria that are components of the Apgar systems are the norm. This level shows the normal reactions of the body and the willingness of the newborn to the beginning of life outside the uterine environment.

A child who has received such an assessment does not require further examination and observation by the medical staff and the mother is passed if there is no need for her postnatal medical help.

Forecast

Any assessment of this scale, which seems at first glance, the objective, is exposed to one particular specialist and it can not be considered "the ultimate truth."

That is why, even if we get a kid a low Apgar score at birth, mothers should remember that compliance with the recommendations of experts, as well as unconditional love for her child is able to fundamentally fix situation.

Medical staff of maternity hospitals have enough equipment for the control and positive impact on the existing birth abnormalities in the child's condition. Letting go of the mother institution and the newborn after birth, doctors will make the corresponding forecasts for further development and health of your baby, as well as give recommendations to parents in each case.

Apgar in Examples

For the formation of a detailed presentation on the state of the newborn, parents advisable to see examples of estimates of Apgar and transcripts:

• 0/2, 1/2, 2/2, 2/3, 3/3 - condition of the child in this case is considered to be critical and requires immediate emergency medical care;
• 3/4, 4/4, 4/5, 5/6, 6/6 - the health of the baby in such estimates is unstable and requires careful monitoring by neonatologists and pediatricians not only during the first few hours of life, but also throughout the first months;
• 5/7, 6/7, 7/8, 8/8 - receiving such evaluation grudnichok can be considered relatively healthy, but often has a general weakness and wasting body as a whole, hence the need on the part of physicians to monitor its condition during the first days after birth;
• 8/9, 9/9, 9/10, 10/10 - indicators of inherent completely healthy children are not in need of specific care and supervision by medical personnel.

Apgar score is used to assess the state of the newborn has been for many years, it is only relatively objective method of rapid determination of the need for resuscitation for the baby.

Having carefully examined the above information, parents will be able to understand how the experts assess the health the child with the help of this system, as well as whether or not to worry about the announced number of points on doctors Apgar.

Useful video of Apgar and deciphering evaluation

What is the Apgar score:

How is the score: