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What is the Apgar score?
Most term infants make a successful and uneventful transition from living within the womb to the outside world. Some will need some medical intervention, and very few will require extensive resuscitation. A reproducible and rapidly determined rating system is necessary for evaluation of the condition of the newborn infant. The Apgar score is a practical method for assessing a neonate.
How is the Apgar score done?
The Apgar score is a number calculated by scoring the heart rate, respiratory effort, muscle tone, skin color, and reflex irritability (response to a catheter in the nostril). Each of these objective signs can receive 0, 1, or 2 points.
What does a high or low Apgar score mean?
A perfect Apgar score of 10 means an infant is in the best possible condition. An infant with an Apgar score of 0-3 needs immediate resuscitation. It is important to note that diligent care of the newborn is an immediate response to the current status of the infant. It is inappropriate to wait until Apgar scores are obtained to begin or continue to address the needs of the neonate.
When is the Apgar scoring done?
The Apgar score is done routinely 60 seconds after the birth of the infant and then is repeated five minutes after birth.
In the event of a difficult resuscitation, the Apgar score may be done again at 10, 15, and 20 minutes.
What does a persistently low Apgar score mean?
The persistence of low (0-3) Apgar scores at 20 minutes of age is predictive of high rates of morbidity (disease) and mortality (death). In term infants, the five-minute Apgar score is predictive of mortality but is not as precise a predictor for neurologic and developmental disabilities. In high-risk (prematurity, low birth weight, etc.) infants, Apgar scores are less sensitive regarding long- term predictions of mental and neurological health.
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Why was the Apgar score developed?
The score is named for the preeminent American anesthesiologist Dr. Virginia Apgar (1909-1974), who invented the scoring method in 1952. Having assisted at thousands of deliveries, Dr. Apgar wished to focus attention on the baby. Babies were traditionally dispatched directly to the nursery, often without much formal scrutiny after delivery. Apgar wanted the baby to be assessed in an organized, meaningful manner by the delivery-room personnel. Dr. Apgar was the first woman to be appointed a full professor at Columbia University's College of Physicians and Surgeons.
American Academy of Pediatrics. "Use and Abuse of the Apgar Score." Pediatrics 78.6 Dec. 1986: 1148-1149.
Cash, Sheryl. "What's in a Score -- Revised Policy Statement Cautions Against Using the Apgar Score as a Prognostic Tool." AAP News 27.4 Apr. 2006: 1-5.
Iyer, Ravi. "The Apgar Score." Pediatrics 118.3 Sept. 2006: 1314.
Top Apgar Score Related Articles
Birth DefectsBirth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
Children's HealthChildren's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health, and community health.
Chorionic Villus SamplingThis prenatal test involves taking a small sample of cells from the placenta to check for birth defects, genetic diseases, and other problems. Candidates for the test include pregnant women age 35 years or older, couples who have had a child with a birth defect, and pregnant woman who have had other abnormal genetic test results. Potential risks of the test include miscarriage and infection. Cells may be collected through the vagina or through the abdomen.
Detecting Hearing Loss in ChildrenThere are many degrees of hearing, from normal hearing to deafness. Many states mandate the testing of newborns before leaving the hospital. The risk factors for hearing loss in children include
- a family history of hearing loss,
- frequent ear infections,
- diagnosis of a learning disability,
- syndromes associated with hearing loss,
- speech delay, and
- infectious diseases that cause hearing loss.
- the child not responding to his or her name,
- the child asking for words to be repeated, and
- the child not paying attention to what is being said.
Labor and DeliveryLabor signs can be very distinct for pregnant women. It is not possible to know what causes labor to start or when exactly it will start, but changes that indicate the beginning of labor include lightening, passing of the mucus plug, contractions, breaking the bag of water, and effacement and dilation of the cervix.
Mental Health (Psychology)Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
Newborn Infant Hearing ScreeningA newborn infant hearing screening is performed before a child is discharged from the hospital. If an infant doesn't pass the test, a rescreen is performed. Detecting hearing loss at an early age increases a child's chance of having a healthy and more productive life. There are two methods of testing hearing in infants: auditory brainstem response (ABR) and otoacoustic emission (OAE). Both tests are accurate, automated, and don't require a visible response from the infant.
Pregnancy Drug DangersTaking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Pregnancy Induced HypertensionPreeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
Pregnancy Planning (Preparing for Pregnancy)
Pregnancy planning is an important step in preparation for starting or expanding a family. Planning for a pregnancy includes:
- Taking prenatal vitamins
- Eating healthy for you and your baby
- Disease prevention (for both parents and baby) to prevent birth defects and infections
- Avoiding certain medications that may be harmful to your baby
- How much weight gain is healthy
- Exercise safety and pregnancy
- Travel during pregnancy
Women's HealthWomen's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.