Silverman scale and Apgar scale: assess the health of newborns

It is not a secret for anyone that the emergence ofthe baby is a serious test not only for the mother, but also for him. After all, in just a few seconds the life of this crumb is changing dramatically: all nine months he lived with his mother in the tummy and splashed in amniotic fluid, and now he met with a new environment where the air is too hard for his gentle lungs and too cold for the skin. And it's just terrible for a toddler to get into an unfamiliar situation, in which he will now live. One of the methods for determining the state of the newborn in the first moments of his birth is the Silverman scale and the Apgar scale, which will be discussed in this article.

Now - for himself!

Throughout all the long months of pregnancy in thethe tummy of the future mother was given crumbs with the oxygen of the umbilical cord and the placenta. But after birth the baby can count only on himself. Now breathe, warm up, he will need to eat alone. The moment of transition to this new independence for crumbs is so fast that, unfortunately, not all karapuzikov can cope with this.

A number of newborns need helpspecialists. In the case of its timely rendering, the condition of the kids comes back to normal. True, some may not survive unless serious reanimation measures are applied to them.

These important first seconds

It is in this short period of time, when the accountgoes literally for a second in the matter of assessing the state of the youngster, in the first moments of life it is advisable to use special scales. They allow doctors to take a quick, accurate, right decision for this situation and understand how this child needs specialized care and care. The most famous and commonly used in maternity hospitals are the Silverman scale, which is used to determine the severity of the condition of a newborn baby with breathing problems, and the Apgar scale, which many years ago was developed by the American anesthesiologist Virginia Apgar. It is through these two most important tools that one can form an idea of ​​the health of crumbs.

Determining the state of the baby on the Apgar scale

To objectively characterize the statethe newly born baby, doctors use the work of the American anesthesiologist. Assessment on the Apgar scale during the first minute of life the youngster controls five of the most important clinical signs: the rhythm and frequency of the heartbeat, the nature of the muscle tone and breathing, as well as the color of the skin and the state of the crumbling reflexes. Depending on how pronounced these signs are, doctors put an estimate in points for each of them: each of the five parameters gets from zero to two units.

The maximum number of points that can bebe delivered to the baby. - 10. The results are usually recorded twice: the first - immediately after the first breath of the baby, in order to understand how he feels himself at that moment; the second - five minutes after his birth, to determine how the baby began to adapt to new, completely unusual for him conditions. If doctors conducted emergency resuscitation measures, the second assessment shows how effective they were.

The normal result is a score on a scaleApgar from 7 to 10 points; a satisfactory state of the carapaces, which scored 4-6 points (they need timely medical help); If the baby gets less than 4 points, resuscitation procedures should be performed immediately.

Determining the state of the baby on the scale of Silverman

In order to diagnose as early as possiblerespiratory disorders in children who were born before the due date, the Silverman scale is applied. The study is carried out immediately after birth, and then after two, six, twelve and twenty-four hours of life, crumbs. Specialists observe how the thorax moves, how intercostal and sternum are involved, what is the position of the lower jaw, the breathing of the baby.

All these signs are evaluated, as well as on a scaleApgar, in the range from zero to two points. But there is a very important difference: when assessing newborns on the Apgar scale, the best is the highest score - two. And the more points the child collects, the better.

The Silverman scale is used to estimatea newborn in the same way, but in this case, the fewer scores the baby gains, the better, because it indicates that the degree of severity of the manifestation of respiratory problems is not high and can be adjusted.

And suddenly a newborn SDR ...

If the baby was born prematurely, then quiteit is likely that he may have SDR - a syndrome of respiratory distress. For this pathology, the symptomatology of the circulatory system is characteristic: in crumbs, blood pressure decreases, microcirculation is disrupted, tachycardia appears. The doctor can determine some muted tones.

With SDR, there may be an increase in the liverchild. Perhaps the development of hypovolemia, which often leads to fluid retention in the body and peripheral edema. The central nervous system can be depressed, a periventricular hemorrhage can be detected in the baby. And until now doctors can not answer the question about what is still primary - the brain damage to the child or his lungs.

Help thanks to scores

So, we figured out the main thing: just at the moment when the account of time is not even for minutes, but for seconds, doctors use special scales to assess the state of newborn babies in the very first moments of their life. Thanks to these scales, people in white coats can very quickly make the right decision about how much the child needs specialized help.

It is the Apgar / Silverman scale that gives allnecessary information on how to act neonatologists in this or that case. Timely provision of the required assistance will positively affect the child's health in the future. A Silverman's scale also provides the necessary information about the state of health of premature babies.