Score on the Apgar scale

The Apgar scale is named for Virginia Apgar, an American anesthesiologist. For the first time this system of state evaluationThe newborn in the first minutes of life was introduced in 1952. Apgar score is used to determine if a newborn baby needs to be in intensive care or more closely monitored.

Exist five evaluation criteria on the Apgar scale, each of which is estimated at 0, 1 or 2 points. 2 points - the sign is pronounced, 1 point - the sign is weakly expressed, 0 points - the sign is missing.

Then the scores for each feature are added together, the total amount can be from 0 to 10 points. In 1963, pediatrician Josef Butterfield introduceda mnemonic rule for English-speaking experts, which makes it easier to remember the criteria for the Apgar scale: each criterion starts with one of the letters of the word Apgar. Let's analyze each criterion of the scale.

A - Appearance - appearance (coloring of the skin). At 2 points, the pink color of allbody, including limbs. At 1 point - cyanotic color of the limbs with a pink color of the body. At 0 points - pale or cyanotic color of the entire skin.

P - Pulse - pulse (heart rate). 2 points - heart rate more than 100 beats per minute, 1 point - heart rate is less than 100 beats per minute, 0 points - no heart beat.

G - Grimace - grimace, which occurs in response to excitation (reflex excitability). At 2 points, the following reactions are evaluated: motion, coughing, sneezing, loud screaming. At 1 point - a weakly expressed reaction (grimace, movement). At 0 points - no response.

A - Activity - activity of movements (muscle tone). Scores of 2 points are awarded pronounced active movements. In 1 point - reduced muscle tone, some flexion of limbs. In 0 points - absent muscle tone, hanging limbs.

R - Respiration - respiration (respiratory movement). At 2 points, normal breathing (40-45 respiratory movements per minute) and a loud scream are evaluated. At 1 point - irregular breathing and a weak cry (hypoventilation). 0 points - lack of breathing.

The Apgar score is usually performed the first minute after birth, and after five minutes the test is repeated (usually the second indicator is higher than the first). The norm is considered to be higher than 7 points, the score below 3 points indicates a critical condition of the newborn. An ideal score of 10 points is extremely rare, it is received no more than 15% of newborns.

Initially, the Apgar scale was developed not for parents, but for medical personnel. Evaluation of a newborn on the Apgar scale helps to determine whether it requires more careful monitoring. A child who received less than 5 points needsurgent resuscitation. The child, whose condition was estimated at 5-6 points, needs close monitoring. If 5 minutes after birth, this figure rose to normal, the need for careful observation is no longer needed, but if he remained at the level of 5-6 points, the child will continue to be under more careful supervision.

Preterm infants are assessed on the Apgar scale not twice, but three times: in a minute, in 10-15 minutes and after twohours after birth. The last evaluation is considered prognostic for the subsequent development of the child. However, other methods are used to evaluate preterm infants, and not just the Apgar scale.

Parents should remember that evaluation is below the norm - not a reason for panic. Timely and correct medical care usually gives the child the opportunity to develop normally in the future, in no way lagging behind their peers.