How is the Apgar scoring done?

How is the Apgar scoring done?

This evaluation test is given through a score that ranges from 1 to 10 points, depending on the response that the child gives to each organ check; With this information, a picture of the general state and vitality of the newborn is raised. This measurement is made at the minute of birth, at 5 minutes, and 10.

This examines your heart rate, reflexes, muscle tone, and skin color. The ideal score should be between 8 and 10; If they obtain 4 to 6 points, their physical condition is inadequate, and the neonatologist will request a clinical evaluation to initiate recovery. But if the score is less than 4, it requires immediate attention with medications and assisted breathing.

In the 61 years that this test has been performed, morbidity rates in newborns have been reduced by more than 50 percent, thanks to the fact that it provides valuable information on the health and general condition of the baby.

How is the Apgar scoring done?

The aspects that are scored in the Apgar test are 5, and each one is valued from 0 to 2, so the perfect score is ten if it meets the five aspects exactly.

1. Heart rate: the ideal rate is more significant than 100 beats per minute; if so, you will receive 2 points.

2. Respiratory effort: it is measured through crying. If this is good, you will be awarded 2 points.

3. Muscle tone: he is expected to be an active baby, and thus he will receive two more points, but if this is flaccid, his score will be 0.

4. Reflex of irritability: here, the level of response of the child to stimuli, such as a tiny pinprick, is measured. So if your cry is vigorous, you will receive two more points.

5. Skin coloration: if it is pale blue, it will have 0 points; if your body is pink, but the limbs are blue, you will get 1 point, and if your entire body is pink, you will get 2 points.

When the score obtained in any level is 0, that is, very low, the neonatologist may decide that the baby goes to the incubator to be carefully observed for a few more hours.

According to Daniel Felipe Martín Suárez, if a child does not undergo this screening, there is a risk that certain congenital anomalies will not be identified early, that it has medical treatment and, at the same time,? It could not be identified if the newborn is born healthy or not, which would increase perinatal mortality rates?
An observational study carried out on more than 1.5 million babies and published in “BMJ” warns that scores on the Apgar test – the test that evaluates newborns shortly after birth – between 7, 8, and 9 -considered within the normal range- are associated with higher risks of disease and even death in newborns.

The odds of problems increase with “normal” scores less than 10, but the researchers emphasize that the risk remains low and certainly lower than for babies with scores outside the normal range. Apgar refers to Appearance -skin color-, Pulse -heart rate-, Reaction when stimulated -reflex response-, Activity -muscle tone- and Respiration -respiratory rhythm and respiratory effort-. The five values ​​are added together to get an overall score of zero to 10.

The test is performed on the baby on two occasions: at one minute of birth and five minutes. Sometimes, if the baby’s physical condition is worrying, the baby can be evaluated a third time in 10 minutes.

Scores of less than seven are considered low and are known to carry an increased risk of infections and respiratory problems, and long-term problems such as epilepsy or cerebral palsy.
The test is performed on the baby on two occasions: at one minute of birth and five minutes.

7-10 is considered “within the normal range” and therefore reassuring. But no study has investigated whether average scores of 7, 8, or 9 are associated with a higher risk of illness or death than a score of 10.
7-10 is considered “within the normal range” and therefore reassuring. But no study has investigated whether average scores of 7, 8, or 9 are associated with a higher risk of illness or death than a score of 10.

The team led by Neda Razaz, the Karolinska Institute (Sweden), has compared the associations between scores of 7, 8, and 9 (versus 10) with illness and death in newborns.

After analyzing data from more than 1.5 million Swedish babies born full-term between 1999 and 2016, and after considering several factors, such as the mother’s age, weight (BMI), and smoking during pregnancy, the researchers found that a score of 7, 8, and 9 at minute one, five, and ten after birth was associated with an increased risk of infections, respiratory problems, brain injury as a result of lack of oxygen, low blood sugar levels. Blood and death compared to babies who had a score of 10.

The researchers caution that this is an observational study, so they cannot establish the cause.

In summary, the authors stress that their findings provide “strong evidence to support the proposition that the optimal Apgar score is ten at each time point (1, 5, and 10) and that all newborns should be assigned an Apgar score at 10 minutes, regardless of your score at minute 1 and 5 ».

In 1952, the anesthesiologist Virginia Apgar devised the test that bears her name when she detected the imperative need to provide some standard for the clinical evaluation of newborns.

Since then, the method has reduced the mortality rate and has led to a considerable decrease in the probability of developing diseases in millions of babies, how? with the simple fact of evaluating vitality indices of newborns immediately after birth.

The most critical stage in your baby’s life is the first ten minutes after birth. The Apgar test aims to carry out a scoring scheme at one minute, at five minutes, and in some cases, at 10 minutes after birth, and with this, the baby’s general condition is evaluated.

Five main vital signs are evaluated: skin color (pale/pink / bluish); muscle tone (strength of movements and flexion of the limbs); breathing (slow or no); heart rate and reflexes to stimuli (this is if there is a cough or sneeze when the baby is aspirated with a nasal tube)

How is the scoring done? Each of these parameters is scored from 0 to 2, and the sum of the five reaches a maximum score of 10. According to the number of scores, the baby’s health status will be established (but that is something that should be discussed with the doctor, who is the one who will know how to guide you best).

Five minutes after the first evaluation, the test is repeated. What is weighted is the degree of adaptation of the baby to the environment. The result of this second test is usually compared with the first to get a better picture of the baby’s health.