The Apgar Score
The Apgar Score consists of a group of parameters that were developed by Dr Virginia Apgar in 1952 (Watterberg et al., 2015). The Apgar score has become a widely used method to assess the overall status of the infant and to measure if the newborn is responding to resuscitation (Watterberg et al., 2015). Resuscitation needs to be initiated prior to the 1 minute Apgar score (Watterberg et al., 2015) (Pairman et al., 2015).
A neonate is given an overall Apgar score between 0-10 at both 1 minute and again at 5 minutes after birth. This is based on the neonate’s heart rate, respiratory effort, muscle tone, reflex irritability and skin colour (Crisp et al., 2014).
There are many factors that can impact upon the Apgar score such as length of fetal gestation, medications used during pregnancy and childbirth, resuscitation and neurological abnormalities (Watterberg et al., 2015). In the case of a neonate receiving an Apgar score less than 7 at the 5-minutes check, the Apgar score is repeated every 5 minutes for 20 minutes after the birth or until the newborn’s condition stabilises (Watterberg et al., 2015) (Crisp et al., 2014).
Table 1.
Sign
Score 0
Score 1
Score 2
Heart rate
Absent
Slow ( 100 bpm
Respiratory effort
Absent
Slow, irregular, hypoventilation
Good, crying lustily
Muscle tone
Absent
Some flexion in extremities
The authors recommend after the first afterbirth check takes place at 30 seconds and includes additional considerations to the Apgar score such as that of the gestation period (ie. preterm), meconium in the amniotic fluid or on the skin and any congenital abnormalities that are visible (Pairman et al.,
These women could anticipate delays in normal growth and development for the fetus. The exact cause of post term pregnancy is unknown. The mother experiencing post term pregnancy is at risk for trauma, hemorrhage, infection, and labor abnormalities (Ward et al., 2016, p. 543). Labor induction prior to 42 weeks’ gestation prevents MAS and other complications. A biophysical profile measuring the heart rate, breathing and body movements, tone, and the amniotic fluid volume is used to monitor the fetus for intrapartum fetal stress that could cause passage of meconium. Diabetic woman is at high risk for preeclampsia or eclampsia, infection, hydramnios, postpartum hemorrhage, and cesarean birth (Ward et al., 2016, p. 383). In addition, fetal macrosomia prolongs labor due to shoulder dystocia. The glucose challenge test, and the 3- hour OGTT is used for gestational diabetes screening, done after 24 weeks of pregnancy. Abnormalities of the respiratory system as explained earlier are the most concerning complication of MAS, needing immediate
Many methods of screening have been implemented including neonatal sampling of hair and meconium, maternal urine screening, and maternal self-reports.(11) In considering wide-spread feasibility, self-report measures have been commonly used, some more known and validated methods include the 4 P’s plus and TWEAK. (4,5,13) In the clinic visit, the Obstetrician may also implement a brief motivational interview to assess the patients willingness to change. The Treatment and Intervention Protocol recommends the FRAMES Approach where the providers give feedback, responsibility, advice, menus of change options, empathy, and empowers t...
To determine trends in Birth weights, APGAR scores and NICU stay of the neonates born to PCOS mothers.
From year to year, the number of SIDS deaths tends to remain constant despite fluctuations in the overall number of infant deaths. The National Center for Health Statistics (NCHS) report...
have higher rates of low birth weighted need special care right after birth for times as
...e baby still seems to have too much fluid in his or hers mouth or nose, the nurse may do further suctioning at this time. At one and five minutes after birth, an Apgar assessment will be done to evaluate the baby's heart rate, breathing, muscle tone, reflex response, and color. If the baby is doing well, the mother and the baby will not be separated. The nurse will come in from time to time to change diapers, check the babies temperature, and perform other tasks while the baby spends time with his or her mother and father (B. C. Board).
After I got acquainted with MK, which I found difficult because of the way I held him and the absence of a motherly scent, I performed to the best of my ability an assessment based on the Apgar scale along with a physical assessment. MK’s weight was around 180 ounces and he was 58 cm in length with a head circumference of 33 cm. I asked about weight gain or loss patterns that the parents noticed. They replied nothing significant, just a slight drop in weight after a few days starting from delivery then steady weight gain. This can be attributed to fluid losses by respiration, urination, defecation, and low fluid intake. (Potter, Perry, Ross-Kerr, & Wood, 2009, p. 333) I also noticed that MK was using abdominal muscles for breathing at around 40 breaths per minute. His heart rate was around 130 bpm. His skin was a nice pink color; however, his parents mentioned he was bit yellow right after birth for a few days. This phenomenon can be attributed to an excess of bilirubin and the immaturity of the liver. MK received a 10 on the Apgar scale which measures Heart Rate, Respiratory Effort, Muscle Tone, Reflex/Irritability and Color of the body. Afterwards I tested for the presence of innate reflexes including: Mo...
This paper will then explain the types of physical symptoms associated with NAS in the full-term and premature infant. It discusses the different classes of drugs and the unique symptoms newborns experience with each. Furthermore, it discusses the long-term cognitive and behavioral effects that newborns can experience as they grow. In addition, this paper discusses how Neonatal Abstinence Syndrome is diagnosed and the how the Finnegan neonatal scoring system is used to help physicians determine the severity of NAS in each newborn. Lastly, this paper explains the treatment for NAS and the important role of the nurse when caring for a newborn with Neonatal Abstinence Syndrome.
Every day, 370,000 babies are born into this world- each having the potential to live a prosperous and productive life. Unfortunately, some of these tiny, fragile humans do not live until their first birthday. The death of infants within the first year of life is known as infant mortality. There are many contributing factors as to why infant mortality may be high or low in a specific area. In order to measure the amount of deaths that occur in a particular region, the number of newborns that die before the age of one year old per 1,000 live births are recorded and is known as the infant mortality rate in that society. Generally, the infant mortality rate of a country directly reflects on the health-care system provided. Unfortunately, in today’s world, a child dies every four seconds.
Performance Characteristics of Postpartum Screening Tests for Type 2 Diabetes Mellitus in Women with a History of Gestational Diabetes Mellitus: A Systematic Review, 18(7), Retrieved from http://lib-proxy.calumet.purdue.edu:2461/ehost/pdfviewer/pdfviewer?hid=15&sid=af725124-1c4c-4d18-9e92-35d14ad23d66%40sessionmgr4&vid=15&sid=af Diabetes Information Hub -. (2011). The 'Standard' of the 'Standard'. Retrieved from http://diabetesinformationhub.com/GestationalDiabetes.php. Mayo Clinic. (2010).
Black, M.M., & Matula, K. (1999). Essentials of bayley scales of infant development II assessment. Department of pediatrics; University of Maryland school of medicine, 1.
Postpartum care of the patient diagnosed with gestational diabetes should also include glucose testing. Glucose should be tested at the six week appointment and then at least every three years thereafter. In subsequent pregnancies glucose should be checked early on in pregnancy because of increased risk of developing gestational diabetes. (NDEP, 2013)
Wisborg, K., Kesmodel, U., Tine, B. H., Sjurdur, F. O., & Secher, N. J. (2000). A prospective study of smoking during pregnancy and SIDS. Archives of Disease in Childhood, 83(3), 203-6. Retrieved from http://search.proquest.com/docview/196895386?accountid=41057
The process of human development is very complex. It is a continual process, providing gradual development for the fetus. Some of the most important factors to fetal development such as blood flow, heart beats, muscle development, and brain activity can all be determined within the first seven weeks of pregnancy (Baby Developme...
Only viable fetuses are monitored, because no obstetric intervention will alter the outcome of a pre-viable fetus. Determination of fetal viability is subject to institutional variation: an estimated gestational age of 20 - 26 weeks and an estimated fetal weight of 500g. Are commonly used thresholds of viability. Therefore, patients who have minor trauma and who are at less than 20 weeks gestation do not require specific intervention or monitoring. All pregnant women beyond 20 weeks’ gestation should undergo a minimum of 4 - 24 hours, and in some cases as long as 48 hours of monitoring. Fetal distress may be the first sign of maternal hemodynamic compromise and fetal distress, and to identify possible placenta abruption.