Uncomplicated Delivery Room Course
A pediatrician is usually not present at a normal delivery.
More Info: APGAR Score
The Apgar scoring system was developed in 1951 by Dr. Virginia Apgar to evaluate the baby's cardiovascular system immediately after birth and to identify babies at risk for future complications.
The Apgar score is determined by evaluating the newborn baby on five criteria, each assessed on a scale from zero to two, then summing up the five values. The resulting Apgar score can range from zero to 10.
The baby is scored twice - at one minute and again at five minutes. Most babies will have a one-minute score of 8 of 9.
A low Apgar score may be due to intrauterine asphyxia, hypovolemia, drugs administered to the mother that depress fetal respiratory efforts, severe perinatal infection, or congenital abnormalities involving the lungs, heart, of the central nervous system.
|
Score |
0 |
1 |
2 |
|
Appearance of extremities |
blue/pale |
pink/ |
pink/blue |
|
Pulse |
absent |
< 100 bpm |
> 100 pbm |
|
Grimace |
absent |
grimace |
crying actively |
|
Activity |
limp |
some flexion |
moving actively |
|
Respiration |
absent |
irregular |
regular, crying |
The one-minute Apgar score serves as a guideline for the degree of intervention. The five-minute score is an indicator of the efficacy of the resuscitative efforts, if any were necessary. In and of itself, the one- and five-minute Apgar scores are not good predictors of long-term outcome, but may predict a complicated neonatal course, which then increases risk for poor long-term outcome.
Apgar from National Library of Medicine
Immediately after delivery, the infant is wrapped in a sterile towel, wiped dry, placed in a slightly head-down position under a radiant warmer and given oxygen if necessary.
The airway is cleared by aspirating the nose and throat gently with a rubber bulb or suction catheter and the infant is stimulated if respirations are not vigorous. The heart sounds and lungs are auscultated and excursion of the chest is observed. The Apgar score, which reflects newborn health, is determined at one and five minutes. The baby is given to the mother for skin to skin contact for the first hour (kangaroo care) and remains with the mother for the duration of the hospital stay (rooming in).
