Apgar scale 8 8b what does it mean. Apgar scale for newborns. What pathological processes are identified during scoring?

When a baby is just born, he passes the first test of independence in his life. Strict judges are doctors who give scores on the Apgar scale and enter them in the child’s first “diary” - a discharge document for the children’s clinic.

For the uninitiated, the test results look, at least, quite strange - 6/8, 7/9, 8/9... Do you want to know what they mean? To do this, you need to understand what this mysterious Apgar scale actually is?

First, a little history. In 1952, the famous American anesthesiologist Virginia Apgar developed a specialized system for assessing the condition of newborns. Each letter in the APGAR test corresponds to a specific body function:

A (appearnce) – skin color

P (puls) - pulse

G (grimace) – grimaces

A (activity) – activity

R (respiracon) – breathing

Apgar testing is a system for quickly assessing the condition of a newborn and determining the need for resuscitation measures. The test is a summary analysis of the five most important criteria: skin color, heart rate, reflex excitability, breathing and muscle tone. For each item, the newborn is given a score from 0 to 2. Then the results are summed up and a total score is given from 0 to 10 points.

The baby was born, the doctors pumped out the mucus from the upper respiratory tract and the baby screamed or coughed loudly - this is the correct 2 points.

If you start to grimace, but breathe unevenly - only 1 point.

Actively rolled up his arms and legs - the highest score!

Undoubtedly, there are more accurate indicators of the condition of the newborn (for example, oxygen tension in the umbilical cord blood). But to determine this, you need to conduct a special analysis. And the Apgar scale makes it possible to very accurately assess the baby’s condition with the naked eye. Moreover, evaluate it in the first minutes of birth, which is very important. Often, help needs to be provided to the baby immediately and there is simply no time for additional research. An experienced doctor will need only 40-60 seconds to conduct the test, which means a professional can determine the condition of the baby almost with lightning speed.

If the baby scores low, he needs medical attention. However, test results may vary. To do this, it is carried out at least twice - at 1 and 5 minutes after birth (hence the double score: for example, at the first minute 6, at the second 9, it turns out 6/9). It often happens that at 1 minute the baby receives a very low score. But after resuscitation procedures, he gains the necessary points. The baby just needed time and help to adapt to new, unusual conditions.

If during the second test the Apgar score is less than 7 points, the baby will be tested again every 5 minutes for the next 20 minutes and the necessary procedures will be carried out at the same time.

Excellent rating

10-9 points - the baby is healthy, all body systems are activated on time and the newborn does not need medical attention.

Rated "good"

8-7 points - the baby passed the exam, the doctors have no special reasons for worry (the baby suffered acute oxygen starvation, but then his condition stabilized).

Rating "satisfactory"

6-5 - the situation is not very good, the baby will most likely be placed in the pediatric intensive care unit under the supervision of nurses. Here they will monitor the vital functions of the body. The baby will be brought to the mother when all body systems begin to work stably.

Rating "poor"

4-0 points – the newborn needs emergency care, resuscitation measures must be taken urgently (since there is a danger to the child’s life).

Only 15% of newborns receive 10 points in the first minute. Most babies need some time for all body systems to work at full capacity outside the mother's body.

Borderline score – 7 points. In this case, a lot depends on the professionalism of the doctors and on how the baby adapts to new conditions.

The first assessment indicates the amount of necessary assistance that needs to be provided to the baby. But it’s not an indicator of the baby’s further development. But the second assessment can already predict health problems. Therefore, if the second score is low, the baby will be observed by a neurologist for the first year of life. The lower the second score, the higher the likelihood of damage to the central nervous system.

As a rule, a low score is due to the fact that the baby experienced oxygen starvation, that is, was in a state of hypoxia (chronic hypoxia - oxygen starvation during pregnancy and acute hypoxia - oxygen starvation during childbirth). Premature babies often have lower scores than full-term babies.

Apgar scores are included in the statement for the children's clinic, which is handed out to them. Many parents are frightened when they see that the child did not immediately become an “excellent student” and his grade is too low. Remember, it has nothing to do with the child’s intellectual potential, but only determines the baby’s condition immediately after birth. Parents' fears are sometimes excessive. Yes, such a baby will need more attention, you may have to take more massage courses and do therapeutic exercises with him. But it's not that difficult! Recent research by doctors confirms that most of these babies grow up normal and quite healthy.

In recent years, there has been a lot of controversy about how objective the Apgar system is. Thus, psychologists say that every baby has its own character and temperament from birth. Obviously, a baby who is more passive from birth will not actively move or scream loudly, and this does not mean at all that he is sick. Future quiet people will most likely just whine and quickly calm down. And the bullies and daredevils will scream loudly as soon as they are born. By the way, Virginia Apgar herself also called her system rather conditional. So it is premature to panic because of low indicators.

Apgar scores, along with height and weight, are the first and most significant in your baby’s life. During the first year of the baby's life, doctors will ask the mother what Apgar score he was born with. So memorize these two numbers and don’t forget, no matter what your baby is, an excellent student or a C student, he really needs your care and love. There are never too many of them.

An Apgar score is given to every newborn baby in the first minutes of his life. This indicator plays an important role in the further diagnosis of the baby. Next, let’s look at what this scale is and what criteria doctors use to rate it.

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What it is

Many young mothers, when discharged from the maternity hospital, do not know what the “Apgar scale” is and do not understand whether everything is normal with their baby. We will try to dispel some myths and figure out what criteria are used to evaluate the health of a newborn on the Apgar scale and what it means.

Important! Since 1952, the concept of the “Apgar scale” has appeared in medicine.

This is an indicator by which the state of health of a newborn child is estimated. This term and method of assessment were introduced by a doctor from America.

The abbreviation APGAR has a meaning, which explains by what criteria the condition of a newborn is assessed on a scale:

A (appearance) which translated means “appearance”. That is, according to this criterion, the color of the child’s skin and his general condition are determined.
P (puls) is a measurement of heart rate.
G (grimace) – facial expression and grimace.
A (activity) – mobility, activity, general muscle tone.
R (respiration) – reflexes and breathing.

All these indicators allow us to assess the baby’s condition and describe his reaction to the ectopic environment. The scale has 10 points. Thus, the health of a newborn child is assessed from 0 to 10 points.

Since the child is examined twice, two values are entered in the card, for example, 7-8 or 8-9, etc. This indicator should be recorded in which will later be pasted into the baby’s card. The pediatrician needs these numbers to understand the child’s condition.

How are points calculated?

What do the numbers mean? The first assessment is based on the health status of the newborn in the first minute of life, regardless of whether the birth was natural or caesarean section. If the baby does not have any reflexes, then a score of 0-1-2 is given, and resuscitation measures are carried out. After this, a health assessment is carried out again.

As already written above, the examination is carried out in the first and fifth minutes of life. If the last measurement below 7 points according to the Apgar scale, then every five minutes it is necessary to conduct an additional examination to track the dynamics of changes in health. If the condition improves, then there is no reason to worry; if it worsens, additional stimulation and resuscitation are required.

Points are calculated as a whole, based on all five criteria. That is, based on examination of the skin, reaction, facial expression, and pulse rate, the average overall score is determined.

In the first minute, 7-8 points on the scale is considered normal; by the fifth minute, 8 or 9 points is an almost ideal state of health.

According to statistics, children with low Apgar scores very quickly catch up, subject to proper care, feeding, and hygiene.

It is important to feed your baby in the first days . If this is not possible, then doctors will recommend a high-quality adapted formula, which is also rich in vitamins and minerals, like mother’s milk.

Norm and deviations

An apgar score of 10 in the first minute is rare. This result occurs in 15% in the world and 5% in our country. Most common meaning 7-9 points, and such children do not need special activities. Regular care and proper feeding are sufficient.

If at birth no heartbeat observed or the pulse is too slow, there are no reflexes, then no more than 3 points are set. After resuscitation, re-evaluation is carried out.

4-6 points are given to those children who do not respond fully to stimuli with a pulse of less than 100 beats. With massage and proper medical care, the condition can be restored in the first five minutes and assessed at 7-8 points.

If a newborn has a low score at birth, this may mean that in the future it will be necessary to undergo diagnostics of the entire body and prescribe treatment.

Only in this case can one hope for a good prognosis.

Although there are exceptions, when at 1 minute the baby has 3 points, and by the fifth or tenth minute it is already 7, which is considered a satisfactory or even good result.

Most often, poor results are associated With , which occurs during labor.

The pediatrician evaluates the newborn using a scale. The process itself takes literally half a minute and this is enough to test the baby for all reflexes.

Apgar score of newborns in the table

Score/criterion	Skin covering	Pulse	Grimace	Activity	Reflexes
0	White or blue	Missing or barely getting through	No reaction	Muscle tone is very weak	None
1	Pink, healthy, limbs a little bluish	Less than 100 beats/minute	Grimaces, grimaces	Slightly bends arms and legs	Weak, slow breathing
2	Completely pink color (most often occurs in children born by cesarean section)	100-140 beats/minute – this is considered the ideal SS frequency	Grimaces, grimaces, coughs, sneezes	Actively moves limbs, turns head	Excellent reflexes, uniform breathing (40-45 breaths), healthy baby cry

Doctors evaluate children based on the presented criteria. For example, when a baby’s all indicators are normal, then for each criterion he scores 2 points and as a result receives 10. Most often, Apgar is 8 points in the first minute in children due to bluishness of the skin. The color darkens a little due to the fact that the water breaks much earlier than the baby is born, so he may not have enough oxygen. If the birth went well and there are no congenital pathologies, then the upper layer of the epidermis turns pink in a matter of minutes. It is because of this that the result is always higher at 5 minutes.

Premature babies always have lower results, and this is not considered a deviation.

Breath

Breathing is assessed on the Apgar scale as one of the first, as this is one of the most important criteria for life:

If breathing is synchronous and uniform without any interruptions, then a high score is given and the doctor proceeds to measure the pulse.
When the baby breathes on his own, but there are interruptions or convulsions, the score is given low, and immediate attention is needed. perform ventilation.
If there is no breathing, the child's Apgar score is 0 and resuscitation begins. First, they try to start the lungs using an oxygen bag, but if there are no results, then the newborn is transported to intensive care and connected to an artificial respiration apparatus.

A child may breathe differently. His lungs have not yet developed and it takes time for him to breathe properly. A healthy baby should do on average about 42 breaths.

Heartbeat assessment

There are several methods by which pediatricians use to estimate the heart rate of a newborn:

listening;
palpation of the cavity on the chest;
palpation of the pulse in the arteries.

The doctor performs palpation for 6 seconds and then multiplies the indicator by 10 to get the result in a minute.

The 6 second method is relevant only when the child is breathing evenly and completely.

Evaluation of the upper layer of the epidermis

If the skin is excessively blue, this indicates a lack of oxygen. In this case, it is necessary to provide the baby with oxygen inhalation until the natural skin color is completely restored.

When the skin is pink or slightly bluish, this is normal. In this case, a score of 7 or more is given on the Apgar scale and the baby is placed on the mother’s chest, or placed on the father’s chest in case of surgery.

Useful video: what is the Apgar scale

Conclusion

In summing up, it is important to note that the Apgar scale is one of the most important criteria by which doctors evaluate the condition of a child in the first minutes of his life. This does not in any way affect further development, physical or mental development. This is a purely individual indicator that makes it possible to understand the newborn’s reaction to the external environment, outside the mother’s womb.

Explanation of newborn indicators

In modern medicine They use the Apgar scale to assess the health of the child immediately after birth.

This technique was developed in 1952 Virginia Apgar from America, who was an anesthesiologist by profession. It turned out to be so universal and easy to use that the scale is still used all over the world, with the only difference being that in some countries it has a different name (adapted to the local language).

The Apgar score is immediately announced to the child’s parents, along with such important indicators as weight and height.

In the abbreviation of the word APGAR, each letter has its own meaning:

Appearance – skin color, Pulse – child’s pulse, Grimace – grimace, facial movements;
Activity – the activity of the movements performed, Respiration – breathing.

This system implies making two assessments, from 0 to 10 points. The first assessment is made within the first minute of the child’s life, the second – after five minutes.

As a rule, the second score exceeds the first by 1-2 points, since the newborn child already has time to “get comfortable” a little.

Points are awarded for mandatory assessment following criteria(where 0 is the minimum value, 1 point is the average value, and 2 points is the high value):

Work of the heart. A neonatologist determines the pulse rate per minute, for this the number of beats in 6 seconds is multiplied by 10. The pulse of newborn babies is more frequent than that of an adult, and is normally about 120-140 beats per minute. The highest score of 2 points is given when the number of beats is 100 per minute or more, 1 point - less than 100 beats, and 0 points - in the absence of cardiac activity, or with single contractions of the heart (in this case, urgent resuscitation is required).
Breath. The number of breaths in a newborn baby varies between 40-45 per minute. If the first breath was accompanied by a loud cry, the baby will receive a score of 2 points, if at birth the cry was weak, more like a groan - 1 point, if there is no cry and weak respiratory activity - 0 points.
Muscle activity. Usually, at birth, children make active movements with their arms and legs, for which they receive 2 points. If muscle activity is weak - 1 point, absent - 0 points.
Presence/absence of reflexes. Already from birth, a little person has such reflexes as breathing, sucking, swallowing, etc. This criterion implies an assessment of their presence.
Skin, color. During a visual examination, the skin and mucous membranes are assessed. Their color should range from light pink to “reddish”. If there is cyanosis - 1 point, general pallor and pronounced cyanosis - 0 points (this may indicate hypoxia or the presence of pathology).

After evaluating all criteria, it displays total score, in practice it never reaches 10 points in the first seconds of life (no more than 15% of newborns receive such a rating).

After five minutes a re-assessment is carried out. If necessary, the child’s condition is assessed several times, every five minutes.

A good indicator is the following values: 8/8, 8/9, 9/9, 9/10, 10/10. In this case, everything is fine with the child, and he is transferred to his mother’s care.

With indicators of 5/7, 6/7, 7/8, the child’s life is not in danger, there are no visible pathologies, but the newborn requires increased attention.

With values of 4/5, 5/6, 6/6, observation by medical personnel is required for at least 5 days, and assistance if necessary.

If the newborn’s Apgar health score is 4/4 points or less, then the condition is regarded as severe and often requires medical intervention and a number of procedures and resuscitation.

U premature babies who were born ahead of schedule, a health rating of 5/7 is already considered good.

Surprisingly, those babies who were born through a cesarean section usually have a fairly high Apgar score, from 8/8 and above. Perhaps this is due to the fact that these children did not go through a difficult and difficult birth path.

Based on all of the above, a health score on the Apgar scale of 8/8 points is good indicator, and there is no reason to worry. After all, as you know, young mothers worry about any reason, and it is better for them to take care of their nerves and health for the sake of the child.

Today, this score of 8/8 points is the most common. This system for assessing the health of a newborn is quick and was created with the goal of identifying the child’s need for urgent resuscitation care. It was created for doctors, and does not affect the child’s health in the future life.

The point system at school is a clear scheme for assessing knowledge according to certain criteria. If we talk about the Apgar score - a system for assessing the health of a newborn, then it is subjective. Compared to school, there is not a wide range of grades. The midwife does them by eye during examination.

In order for future mothers to understand exactly how the condition of their child will be assessed after childbirth, we will consider in detail the principle of this scale itself.

How the scale works

What is the Apgar scale and who is its founder? Virginia Apgar, a famous American professor of anesthesiology, introduced a scale for assessing the health of a newborn child back in the 50s of the last century. The main goal of her method was to promptly identify babies in need of resuscitation measures. Initially, the scale was intended for nursing staff. It was used to determine which child needed more attention.

The technique was named after its founder. Sixty years of experience in using such assessment of a newborn gives reason to believe that the Apgar scale is still quite simple and reliable for a comprehensive assessment. According to many experts, it is a little subjective, because points are given only on the basis of an obstetric examination of the child. The rating scale ranges from 0 to 2 points, where 0 is given for the absence of a certain feature, 1 is given for its average severity, 2 for a well-expressed feature.

Let's look at what exactly is assessed on the scale. It should be noted that for ease of assessment, the English transcription of Mrs. Virginia’s surname was taken. In the word APGAR, each letter stands for a specific evaluation parameter.

A - activity - activity and muscle tone of the child. A healthy baby has arms and legs pressed to the body, fists clenched. The child is active, moves, his face expresses emotions of peace or dissatisfaction with a cry.
P - pulse - pulse. The baby's heart rate is normally 130-140 beats per minute. If this indicator in a newborn is more than one hundred beats per minute, then it is given 2 points, less than one hundred - 1 point, and the absence of heart rate is recorded as 0 points.
G - grimace response - the child’s grimaces, the manifestation and degree of expression of the newborn’s unconditioned reflexes.
A - appearance - skin color and appearance of the child. Shades of pink (from bright to pale) are considered normal. The presence of blueness of the skin, called cyanosis, provides grounds for reducing the score.
R - respiration - the child’s cry, his breathing, reflex excitability. If a newborn screamed loudly and piercingly immediately after birth, then the score for this parameter is 2 points. A weak cry turning into a squeak, low breathing rate is assessed as 1 point. Lack of breathing and screaming - 0 points.

Assessment results and forecasts

The Apgar scale is used to assess the condition of a newborn twice: in the first and fifth minutes of his life. The first minute assessment shows how the baby experienced the birth. The second assessment indicates the degree of its adaptation to the environment.

Condition results are recorded as a fraction, where the first number represents the first assessment and the second number represents the assessment during the second measurement. It should be emphasized that this scale is not the basis for making further forecasts of the child’s condition and health.

Its results are interpreted as follows:

7-10 points - no deviations in health status were identified;
5-6 points - minor deviations;
3-4 points - significant deviations from the norm;
0-2 points - threat to the life of the newborn.

Children with the best results are considered to be in excellent condition and require only routine care. A score of up to 6 points indicates a satisfactory condition and the need for some resuscitation procedures. A child with a score of less than 4 points requires such procedures immediately. If the sum during the second measurement is less than 7, then additional measurements must be taken every 5 minutes. A child who receives 5-6 points on the first measurement and 7-10 on the second goes into the category of healthy children. It should be noted that an Apgar score of 10 is quite rare.

Let us remind you once again about the subjectivity of the Apgar scale and that it is not a method for predicting the development of a baby. Therefore, it cannot be said that a child with a 9-point score will be smarter or healthier than one who received 6 points. The development, health, and abilities of each child are directly proportional to the care, love, and attention of his parents.

Especially for Elena TOLOCHIK

The Apgar scale is used by neonatologists (these are doctors who specialize in newborn babies) and resuscitators to quickly assess the condition of a newly born baby. The data from this assessment must be included in medical documents. This assessment is also reported to parents along with height and weight measurements.

Let's imagine the real situation in the maternity hospital. A mother who has just been transferred from the delivery room to a ward is told: your baby weighs 3200 g, height is 53 cm, and the Apgar score is so many points.

Mommy has not yet fully recovered from the stress of childbirth. What will she mostly understand from this message? Yes, she will understand the information about height and weight. What are these Apgar scores? Is it good or bad? In 90% of cases, this is incomprehensible information for the mother.

Yes, as a rule, these numbers mean absolutely nothing to parents, since they are used in a narrow circle of doctors. Many parents do not understand why their child was given this or that score. Many people ask questions: how important is this indicator, what can it affect in the future?

Today I will try to clearly explain this purely medical technique to interested parents.

A little history

Let's start with a little historical background.

More than half a century ago (1952), anesthesiologist Virginia Apgar from America developed a method for assessing the condition of babies in the first minutes of life.

Since then, resuscitators, neonatologists and pediatricians have used this technique to assess the condition of an infant to determine the need for resuscitation procedures immediately after birth.

Later, in pediatric practice, an easy-to-remember alternative interpretation of the name of the scale was introduced, consonant with the name of the creator. That is, they simply began to call this technique an assessment on the Apgar scale, where each letter of the surname indicates a certain indicator of the baby’s condition.

In assessing the condition of the baby using this method, the following indicators are assessed:

A ppearance - appearance (skin color);

P ulse (Heart Rate) - baby’s pulse (heart rate);

G rimace (Response to Stimulation) - a grimace that occurs in response to irritation;

A ctivity (Muscle Tone) - motor activity, muscle tone;

R espiration - breathing movements.

What is the Apgar score used for?

The Apgar score helps health care providers determine which children require closer monitoring.

The scale is designed to determine the main indicators characterizing the condition of the baby at the 1st and 5th minutes of life.

Sometimes, more often in the case of low primary indicators, specialists continue assessing the scale up to 20 minutes, with an interval of five minutes. Such observation over time also allows us to give an adequate assessment of the medical care provided to the baby.

The assessment of the baby on the Apgar scale should be carried out promptly by specialists. After all, delay at such a moment is unacceptable.

Assessment algorithm

The baby’s condition is assessed using five indicators: pulse, breathing, muscle tone, baby’s skin color and motor activity (reflexes).

Each criterion is scored from 0 to 2 inclusive. In this case, 0 points indicates the absence of a sign, 1 - weak expression, 2 - strong expression. The scores are summed up. The final total score can range from 0 to 10 points.

The Apgar scale is clearly presented in the following table

Feature being assessed	0 points	1 point	2 points
Appearance (Skin Color)	Almost all skin is pale or bluish in color	The skin of the body is pink, the limbs are bluish	The entire surface of the body is pink in color
Baby's pulse	Absent	Less than 100 beats per minute	More than 100 beats per minute
Reflexes	None. No reaction to irritation	Mild reaction in the form of a grimace, movement	Pronounced reaction in the form of animated movement, sneezing, loud screaming
Muscle tone	Absent, baby's limbs hanging down	The tone is reduced, the limbs are slightly bent	Flexion tone is observed, motor activity is pronounced
Breath	Absent	Intermittent shallow breathing, weak cry	Normal breathing, loud scream

Learn more about the evaluation criteria

Newborn skin color (Appearance) is a simple and accessible criterion. At the same time, this indicator is very informative. It allows you to quickly diagnose circulatory disorders.

If we compare this criterion with others, then on this basis children receive the full 2 points less often than on other criteria on the scale.

In principle, this is normal. After all, most children born through natural childbirth have red skin and bluish limbs. In a natural birth, a child spends a lot of strength and energy when passing through the birth canal, and, whatever one may say, in any case experiences moderate oxygen starvation. Hence the changes in skin color.

But “Caesarean children”, born by caesarean section, more often receive two points on this indicator. They were born with less effort and less energy.

Heart rate (Pulse). After birth, a baby’s heart beats very quickly compared to adults. After all, the little one had to work hard.

Normally, the heart rate (HR) of a newly born toddler is 120-140 beats per minute. According to the Apgar scale, a baby's heartbeat faster than 100 beats per minute is assessed with a maximum score of 2 points.

If the child experienced oxygen starvation (hypoxia) in the womb, then after birth such babies experience a slowdown in respiratory and cardiac activity. Then the heart rate is below 100 heart beats per minute.

If there is no cardiac activity immediately after the baby is born, Pulse points are not added.

Reflexes and reactions to stimuli (Grimace). Normally, newly born babies have unconditioned reflexes. Therefore, after birth, babies move actively, take their first breath, and scream loudly.

After birth, the baby is surrounded by many stimuli (light, sound, temperature changes).

Plus, kids also need to endure such an unpleasant medical procedure as suctioning mucus from the nose. The reaction to its implementation can manifest itself to varying degrees.

Lack of response to stimuli is an unsatisfactory indicator and is scored 0 points. A weak reaction in the form of a grimace and inactive movement - 1 point. A reaction in the form of active movement, loud screaming, sneezing, coughing is assessed as 2 points.

Muscle tone (Activity). Normally, a newborn has increased muscle tone. This is to some extent an echo of the forced position in the womb (fetal position).

After birth, the baby’s limbs are normally bent and brought to the body. Active, chaotic, sharp movements of the limbs indicate satisfactory muscle tone.

This condition confirms the good adaptive capabilities of the newborn’s body. Therefore, such children deserve a maximum score of 2 points.

Breathing (Respiration). For a newborn, respiratory activity with a respiratory rate of 40-45 per minute is considered satisfactory and is scored 1 point.

If the baby, having just been born, also screamed loudly, then he will have a maximum Respiration score of 2 points. A loud cry helps the little one breathe more intensely and is considered a sign of the baby’s good adaptive capabilities.

If the baby does not scream immediately after birth, but cries almost silently (“the voice trembles”), and shallow breathing is noted, then his state of the respiratory system will be assessed at 1 point.

In the absence of breathing (asphyxia), points for the Respiration indicator are not calculated.

How to interpret the total score? (from 0 to 10)

10 points is the best indicator. Domestic doctors rarely diagnose it. Abroad, in medical practice, the maximum score can often be found. But our specialists practically do not install it.

And here the reasons for this state of affairs are different for each doctor and in relation to each specific child. You need to understand that the methodology is initially based on a subjective assessment of indicators.

Of course, the peculiarities of the organization of the healthcare system and the peculiarities of the mentality of our people are important here.

Somehow it is not customary for us to declare complete well-being. Especially if the situation may change unexpectedly for any reason. And even more so if we are talking about the fragile body of a baby who has just been born. Therefore, there are probably situations in the category of “playing it safe” or “not to jinx it.”

7-8-9 points is the optimal assessment of the baby’s condition, indicating his good health. Such scores indicate that the period of early adaptation is going well. After birth, the child does not need particularly close supervision by medical staff. All he needs is good care.

5-6 points – the baby’s condition is satisfactory. There are slight deviations from the norm. More careful monitoring by medical staff is required in the postpartum period.

3-4 points – assessment of the condition below average. The child needs medical attention. This indicator requires continued examination according to Apgar criteria at the tenth-fifteenth-twentieth minute of life. Such an assessment will show the results of the resuscitation measures carried out over time.

If the baby was born with an Apgar score of 3-4, he is closely monitored in the first weeks after birth.

0-1-2 points – critical indicators. The baby needs urgent resuscitation care. In the future, such a child must be comprehensively examined and carefully monitored by specialists in dynamics.

I will also clarify in what form the examination results are presented in medical documents.

Since the assessment is carried out twice (in the first and fifth minutes), the result is written in two numbers separated by a slash. For example, 8/9 points.

In most cases, the second estimate is higher than the first. This indicates positive dynamics in the baby’s condition. That is, the child’s adaptive resource is good and is successfully implemented after childbirth.

As a rule, during the second examination, five minutes after birth, the baby’s heart rate increases, breathing normalizes, and the skin acquires a normal pink color. Children become more active. Protective reflexes and reactions to stimuli improve.

If the second score is lowered (9/8 or 8/7), medical monitoring of the newborn is intensified. This means that after birth the baby has difficulty adapting to new conditions.

Maximum rating: parents are happy, doctors are calm

Parents often ask: in what cases is a newborn given a maximum score of 10 points? This has already been discussed in this article above. I repeat once again that our doctors rarely give the maximum score to children.

More often, this score is determined by the subjective opinion of the doctor. But in fairness, it must be said that objective reality often does not contradict subjective assessments. It is rare that a baby, after a labor-intensive process of birth and extreme stress in connection with this, can show high results.

The most common Apgar score for healthy children is 8 points. This means that the baby has a normal score and is given the maximum score for three criteria, although there is a slight decrease (1 point) for two out of five parameters. For example, due to the cyanosis of the limbs and the state of muscle tone.

Every parent is pleased to hear that their child received the maximum grade. But here it is important to understand that the Apgar scale only assesses the viability of the baby and its adaptive capabilities immediately after birth. This scale score is in no way equivalent to any diagnosis.

Therefore, you should not worry at all about a score of 7-8 points. This is an absolutely normal assessment for a newborn.

What depends on mom?

There is no direct relationship between the mother's health status and the baby's Apgar score. But, at the same time, maternal smoking, alcohol consumption during pregnancy, poor nutrition, and untreated chronic foci of infection in a pregnant woman can lead to oxygen starvation and intrauterine infection of the fetus.

This will undoubtedly affect the child’s condition, his respiratory and motor functions after birth. As a result, this will significantly reduce your Apgar score.

At the time of childbirth, a lot also depends on the mother. The color of the baby’s skin immediately after birth will depend on how she pushes and whether she listens and follows the doctors’ instructions during childbirth.

Also, if labor is prolonged due to weak labor, the baby will experience a lack of oxygen for much longer than during the normal duration of labor. And at birth, the activity of the respiratory and cardiovascular systems will be unstable in a rather exhausted baby. Therefore, the baby’s Apgar score will be 1-2 points lower than it would have been during a normal birth.

What can the assessment result influence in the future?

So, if after birth the baby’s Apgar score is greater than or equal to 7-8 points, then the little one is in good condition. Therefore, he can stay with his mother until discharge.

If the baby receives an overall score below 7 points, he will be taken away from his mother for medical care and dynamic observation until his condition stabilizes.

I would like to say that the assessment results do not reflect the full picture of the baby’s health. The purpose of this method is to determine the viability of the baby in a matter of seconds.

This assessment is only relevant at the time of birth. The assessment system helps doctors respond in a timely manner and provide the necessary care to the newborn. It does not make it possible to judge directly the state of health or mental abilities of the baby in the future.

In some situations, specialists in the first year of a baby’s life may pay attention to the amount of Apgar scores. This is sometimes necessary to clarify the picture of the baby’s development from birth.

But over time, these numbers will remain just history, like all other information recorded in the newborn’s discharge.

High Apgar scores are nothing to be proud of. And low numbers are not a reason for additional alarm. That’s why, in order not to worry about not knowing what and why with this rating scale, it’s worth learning about it during pregnancy.