Apgar score for normal birth?

[Audrius 10]

Dear coleagues,

I believe that most of you were in the delivery room and more than one time in your practise. If the baby did not required resuscitation, was he/she rated by Apgar score?

The question is: are healthy babies evalueted by Apgar score in your facilities?

Thank you for responses,

Audrius

[Audrius 10]

Yes

[Guest rafera]

Well, it's nice, You ansvered fot Your question Is it a provocation or something:)

Pozdrowienia:)

[Stefan Johansson 486]

I think Adrius question was meant like a poll/survey.

So, a poll has been added now, please submit your reply there and add any comments below!

BTW, almost all infants born in Sweden have Apgar scores recorded.

Midwifes set the scores in all infants who do not need any interventions by a pediatrician/neonatologist. Otherwise the ped/neo-dr set the scores.

[Guest rafera]

We use Apgar scores for every newborn, even for premature. It's not a ideal score, but for now, it's the best we have". For parents it's the best indicator of condition of their child.

[Guest]

in Scotland we also use the Apgar score for all newborns, if all is well in the delivery room, again the midwife determines the score. Not the best tool, often determined in hindsight, but yes, its all we have too!

[hoangtran 10]

In my centre-Danang Vietnam, we use Apgrar score for all newborn but for resucitation, we are using the flow chart of Neonatal resuscitation from AAP and AHH

[Agnieszka Domanska 13]

We also use Apgar score in all our infants. But we have a problem with scoring the preemies who need resuscitation immediately after birth. When you intubate in the first minute of life - does it make sense to you to score for instance for "breathing" ? If yes - it sounds impossible, because you ventilate the baby.... if not - you have very low scores and that suggest prolonged asphyxia... for example - 4 in the fifth minute. ( 2 only for heart rate and colour, but 0 for breathing, tension and reaction for catheter...) What is your experience/opinion?

[prmenrs 10]

I am a nurse. I have always seen Apgar scores done. If, @ 1 minute, the baby is intubated and being bagged, I would probably score 0, then evaluate for the other criteria. If the Apgar @ 5 minutes was < 6, I would repeat the scoring @ 10 mins.

I've also seen Apgars given by Delivery Room RNs, ALS RNs (in our Level 2 nursery, RNs are trained to resuscitate, intubate, place umbilical lines, etc., until the Neonatalogist and/or transport team arrive). In my previous job, a Level 3 Unit, the residents and fellows gave the score @ the deliveries they attended, otherwise, the Delivery room nurse did it.

[Audrius 10]

Many thanks for replays. Another question: do you think that is reasonable to assess healthy babies by Apgar score? 1.Yes, 2.No, 3.I see no point in this question.

[Stefan Johansson 486]

Dear Adrius, it is not possible to re-start the poll with different alternatives, you would need to start a new thread (by the way, you can add a poll yourself too, when starting a new thread!)

But I suggest we continue the discussion about your second question below.

I think Apgar scores are a quite crude marker of the condition of the infant at birth, but it gives some basic information about the unwell newborn infant. By using it on every child, midwifes and doctors do Apgar scoring "by automatic", also in cases where Apgar scores have some value. But I think you Adrius have a point, scoring the 9-10-10 infants may not be reasonable for its own sake!

[Audrius 10]

Dear Stefan,

Thanks for your replay. The idea of the question was: if people score all the newborns "automatic" or routine, they simply forgets the real signs of Apgar score (this is my experience from many countries wich I have visited). So, my proposal would be to stop scoring healthy babies who don't require any extra help after birth.

Audrius

[Stefan Johansson 486]

The idea of the question was: if people score all the newborns "automatic" or routine, they simply forgets the real signs of Apgar score (this is my experience from many countries wich I have visited). So, my proposal would be to stop scoring healthy babies who don't require any extra help after birth.

I cannot do anything but agree. One should do a study about the reliability of Apgar scoring in healthy term infants. It is quite likely that the 9-10-10-scores for well infants have problems with both sensitivity and specificity (says the perinatal epidemiologist in me). If someone put this idea into practise, please acknowledge 99nicu in the article

[Guest drhassan.nimer@gmail.com]

Dear Colleague, dr Stefan

I think that no doubt that Apgar Scor should be considered and done in ill or healthy babies, why? this is a beginning of the history of the newborn, that shows signs,symptoms, behaviours and other systemic conditions exactly at birth. Without Apgar the physician may mistake or forget some unseen signs. Thank you

dr Hasan N Qasim

pediatrician

[Guest cihanber]

all we are going to talk about one word "apgar" and it means so many things between us.it is important to use one system.

so if we used to record "male/ female" or "gestational age" etc , it is the same to me.

well baby for who ? there are so many different education types in Türkiye also )

have a nice weekend.

[manberbenitez 10]

I think that the apgar score was usefull in his moment, but today we evaluate every newborn baby more especifically because we use the neonatal reanimation program. The Apgar Score sometimes do not denote anything for example in a mother with anesthesia effects. I think in the future we have to make a differente score which really evaluates the hemodinamically condition of a baby and his neurologic outcome. Remember that the great % of babies with cerebral palsy had normal apgar score.

thanks.

[Dr Ashish Jain 11]

What is the neonatl reanimation program ?

[drprasadrao 10]

We use Apgar scores for every newborn, even for premature. It's not a ideal score, but for now, it's the best we have". It is done by the obstetricians & Pediatricians in our place not the midwives.

Dr. Prasad Rao

Pediatrician & Neonatologist

Hyderabad

India

[Guest sjbrott]

Anyone have any info on the "Expanded APGAR?"

[drjha04 10]

Hi

Every baby whether needed resuscitation or not awarded an Apgar score at 1minute and 5 minute and that i think is standard of practice according to NRP guidelines.

Even if there is no Neonatologist or Pediatrician in the Operating room/L&D suites Apgar score is awarded to the baby by Resuscitation Nurse.

[Stefan Johansson 486]

Anyone have any info on the "Expanded APGAR?"

What do you mean by "Expanded Apgar"?

Revised scoring system?

BW, Stefan

[Guest drhassan.nimer@gmail.com]

Dear Colleague, Apgar score is necessary to be recorded for every NB at first and fifth minute.

[Guest pdmuller]

We also use Apgar score in all our infants. But we have a problem with scoring the preemies who need resuscitation immediately after birth. When you intubate in the first minute of life - does it make sense to you to score for instance for "breathing" ? If yes - it sounds impossible, because you ventilate the baby.... if not - you have very low scores and that suggest prolonged asphyxia... for example - 4 in the fifth minute. ( 2 only for heart rate and colour, but 0 for breathing, tension and reaction for catheter...) What is your experience/opinion?

Apgar scores still apply as per usual but specific mention should be made about resuscitation and at what point in time baby was intubated and ventilated. pdmuller

[Guest mbayari]

Hi all,

Nice thread that has been introduced there.

In our practice,we use to score all newborns (midwives or neonatologists). I would like to remind you that when first described by V. Apgar, the score was created for grading newborns and used as a basis for discussion and comparison of the obstetric practices at that time...But, years ago, we are facing a "wrong" use of it; I mean as a marker for later outcomes. Experts have demonstrated that Apgar score is a useful tool for predicting 28day mortality but not risks of disabilities. I agree with Manuel;we have to look for more accurate scores to evaluate our newborns and I think that the SNAP-PE is one of those since it has been stated that it well correlates with MRS results in predicting neurologic outcome.

Hope this help continuing such a research.

[mukes 10]

is ther any better system of scoring than apgar score in term of longterm outcome