APGAR test. Newborn score

APGAR test. Newborn score

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The Apgar test is a test to evaluate the vitality picture of a baby, which is done just when it has just been born. It is assessed through a score determined at the minute of birth, at 5 minutes and, sometimes, at 10 minutes.

The baby's heart rate (the rate of the heartbeat), breathing, muscle tone, reflexes, and skin color are checked.

The score ranges from 1 to 10, depending on the responses that the baby offers at the time of the examination. When the score in any of the times is very low, the neonatologist may indicate that the baby be observed in an incubator during the first hours of life.

At other times, they may recommend admission to a Neonatal ward to investigate the cause of the low score.

The APGAR test score was designed in 1952 by Dr. Virginia Apgar at Columbia University's Babies Hospital. Nevertheless, APGAR is also used as an acronym and its meaning is Appearance, Pulse, Gesticulation, Activity and Respiration.

The test consists of a quick exam, which is performed at the first minute of birth, at the fifth and then, sometimes, at the tenth to determine their physical condition.

The ratio is based on a scale of 1 to 10, where 10 corresponds to the healthiest child and values ​​below 5 indicate that the newborn needs immediate medical assistance to adapt to the new environment.

The expected result is 8 to 9. The score at the first minute assesses the newborn's tolerance level to the birth process and its possible suffering, while the score obtained at 5 minutes assesses the level of adaptability of the newborn to the environment. environment and its resilience.

A newborn with a lower score at the first minute than at the fifth, obtains normal results and does not imply abnormality.

If the baby is in good condition he will obtain a score of 8 to 10 points. If he scores 4 to 6 points, his physiological condition is not responding adequately and the newborn requires a clinical evaluation and immediate recovery.

If it is less than 4, you need emergency care such as IV medications and assisted breathing. Each of these categories is given a score of 0, 1 or 2 depending on the state observed in the newborn.

1. Heart rate
Heart rate is assessed with the stethoscope and is the most important assessment.
If there is no heartbeat, the baby's score is 0 for heart rate.
If the heart rate is less than 100 beats per minute, the baby's heart rate score is 1.
If the heart rate is greater than 100 beats per minute, the baby's heart rate score is 2.

2. Respiratory effort
If there are no breaths, the baby scores 0 for respiratory effort.
If the breaths are slow or irregular, the baby scores 1 for respiratory effort.
If the cry is good, the baby scores 2 for respiratory effort.

3. Baby muscle tone
If the muscle tone is flaccid, the baby's score is 0 for muscle tone.
If there is some flexion of the limbs, the baby scores 1 for muscle tone.
If there is active movement, the baby scores 2 for muscle tone.

4. Irritability reflex
Irritability reflex is a term that describes the newborn's level of irritation in response to stimuli (such as a light pin prick).
If there is no fussy reflex, the baby's score is 0 for fussy reflex.
If there are gesticulations, the baby's score is 1 reflecting irritability.
If there are gesticulations or vigorous coughing, sneezing or crying, the baby's score is 2 reflecting irritability.

5. Baby's skin coloring
If the coloration is pale blue, the baby's score is 0 in coloration.
If the baby's body is pink and the limbs are blue, the score is 1 for coloration.
If the baby's entire body is pink, the score is 2 for coloring.

The 1-minute APGAR score assesses the newborn's tolerance level to the birthing process, while the 5-minute APGAR score assesses the newborn's level of adaptability to the environment.

This exam is an evaluation tool for doctors, helping them determine what kind of immediate help the newborn needs to stabilize. A score of 8 to 10 is normal and indicates that the newborn is in good condition. A score of 10 is very unusual and almost all newborns lose a point for bluish hands and feet.

Any score less than 8 indicates that the child needs help stabilizing. A lower score in the first minute, which normalizes at five minutes, has not been clearly associated with possible long-term negative effects.

Thanks to this method, and during the more than 50 years that it has been carried out, it has been possible to reduce the mortality rate and the morbidity rate, by evaluating the baby's condition immediately after birth. The test ofAPGAR It is a lifetime data for Children's Public Health.

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