Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Apgar Score”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1998

Neonatal neurological examination as a predictor of neuromotor outcome at 4 months in term low-Apgar-score babies in Zimbabwe.

The predictive value of the neonatal neurological examination (NNE) adapted from Prechtl, was investigated in 139 term Zimbabwean infants born with an Apgar score of five or less at 5 min. At 4 months, seven infants had died and 13 were lost to follow-up, leaving 119 infants to undergo the Infant Motor Screen (IMS). Eighty-eight infants were diagnosed as normal, six as suspect and 25 as abnormal at screening. The sensitivity, specificity, positive predictive value and negative predictive value of the NNE were 94%, 55%, 42% and 96%, respectively. Seventeen (14%) infants had developed microcephaly at 4 months and 13 (77%) of them scored abnormal on the IMS. Twenty-three of the 48 (48%) infants who had convulsions within 48 h of birth, were diagnosed as abnormal (P < 0.0001). The NNE proved to be very sensitive in detecting neurodevelopmental abnormalities in the neonatal period and the five abnormal syndromes derived from the NNE were able to correctly identify 94% of the abnormal infants.

Adolescent↗
PubMed2006

Umbilical cord plasma concentrations of free morphine following single-dose diamorphine analgesia and their relationship to dose-delivery time interval, Apgar scores and neonatal respiration.

OBJECTIVE: To find the effect of dose-delivery interval on cord-blood levels of diamorphine metabolites and its effect on Apgar sores and neonatal respiration. STUDY DESIGN: Pilot study conducted in labour ward of a district general hospital. One hundred women who had normal delivery and received single dose of 7.5mg of intramuscular injection of diamorphine in labour were recruited in the study. A 2.0 ml sample of umbilical venous blood was collected from the placenta after delivery of the baby. The sample was analysed using RIA method to measure free morphine. Details about the labour and baby's condition at birth were recorded. RESULTS: The concentration of free morphine in the umbilical venous blood was significantly associated with the dose-delivery interval (coefficient (95% CI)=1.08(0.99-1.18), p<0.001). Twenty neonates had low Apgar score (< or =7) at 1 min. The odds of such a low score were raised with higher log free morphine in the cord venous plasma, but not statistically significantly (OR (95% CI)=5.3 (0.84-34), p=0.08). Fourteen neonates required resuscitation. The odds of requiring resuscitation were significantly raised with higher log free morphine: OR (95% CI)=9.3 (1.0-86), p=0.05. CONCLUSION: Concentration of free morphine in the umbilical venous blood after delivery was significantly associated with the dose-delivery interval and this had significant effect on the need for resuscitation.

Analgesics, Opioid↗
PubMed2001

[Association between gestational age, weight, and Apgar score in newborns extracted in pelvic presentation].

The analysis for the present study was derived from 343 singleton pregnancies with a breech presentation. The variables associated with Apgar score at 5 minutes were, gestational age and birth weight. This association was observed in all patients and when they were analyzed separately according to route of delivery. The intrapartum and early neonatal mortality was absent in both groups. The perinatal outcome among the vaginally delivered frank breech infants at term was not statistically different compared with the group delivered by caesarean section.

Adult↗
PubMed1975

[The effect of lumbar peridural anesthesia with catheter on the maternal and fetal acid-base status and the 1 minute apgar score (author's transl)].

Comparison of 650 deliveries with P.A. and of 928 deliveries without P.A. during the same period. PH from the umbilical artery and 1 minute Apgar score were studied in three groups of patients: 1.) All deliveries, 2.) Spontaneous vaginal deliveries without maternal or fetal risk, 3.) Operative vaginal deliveries. The only significant differences were found among the operative vaginal deliveries: The infants of the peridural group showed a higher incidence of pH-values above 7,2 than those of the non peridural group. Analysis of the maternal acid-base status showed less respiratory alcalosis and less metabolic acidosis in the peridural group. The neonates of this group showed a lower post partum metabolic acidosis than those in the non peridural group.

Acid-Base Equilibrium↗
PubMed2004

Visual function at school age in children with neonatal encephalopathy and low Apgar scores.

OBJECTIVE: To assess different aspects of visual function at school age in children who suffered from neonatal encephalopathy. METHOD: Thirty nine full term infants with neonatal encephalopathy, low Apgar scores, and early neonatal imaging were studied using a battery of tests assessing different aspects of visual function (crowding acuity, stereopsis, visual fields) at school age. The results were compared with brain magnetic resonance imaging (MRI) findings and, when possible, with the results of the assessment of visual function performed at 5 and 12 months, available in 24 of the 39 children examined at school age. RESULTS: Sixteen of the 39 children (41%) had abnormal results at school age in at least one of the visual tests used. Seven of these 16 were untestable on all tests. The remaining 23 children (59%) had normal results. CONCLUSIONS: The presence and severity of visual impairment was related to the severity of brain lesions. Moderate or severe basal ganglia lesions and severe white matter changes were always associated with abnormal visual function. Infants with normal MRI, minimal basal ganglia lesions, and minimal or moderate white matter involvement tended to have normal vision. It was also found that the assessment of visual function performed in the first year was a reliable indicator of visual function at school age. With two exceptions, the results on the 5 month visual assessment were predictive of visual outcome at school age. In the remaining two cases, a normal visual outcome at 5 years was associated with visual abnormalities at 5 months but these had already normalised by the age of 1 year.

Apgar Score↗
PubMed1987

Apgar score, meconium and acidaemia at birth in small-for-gestational age infants born at term, and their relation to neonatal neurological morbidity.

Neonatal neurological morbidity was studied in relation to Apgar score, meconium stained amniotic fluid and acidaemia at birth in 247 small-for-gestational age (SGA) maturely born infants. SGA infants, and especially the severely SGA infants and those born abdominally, showed higher rates of neurological morbidity, acidaemia and meconium stained amniotic fluid than appropriate-for-gestational age (AGA) controls. The examined indicators of asphyxia at birth showed slightly higher correlation coefficients with the 'neonatal neurological optimality score' (NNOS) in SGA, than in AGA term infants, but the percentage of explained variance was low, except in the 23 infants born abdominally. In this group poor neurological outcome was restricted to the 14 infants who showed signs of fetal hypoxaemia diagnosed by decelerative fetal heart rate (FHR) patterns. In 11 of them, FHR decelerations occurred antepartum. These FHR abnormalities appear to be better predictors for the neonatal neurological outcome than indicators of asphyxia at birth.

Apgar Score↗
PubMed1978

Relation between total uterine impulse, method of delivery and one-minute Apgar score.

The resistance to the passage of the fetus during labour has been estimated indirectly by calculation of the total area below the intrauterine pressure curve (total uterine impulse) in two periods during the first stage of labour. A good correlation was found between the total uterine impulse from a cervical dilatation of 5 to 10 cm, the outcome of the second stage of labour and the Apgar score at one minute.

Apgar Score↗
PubMed1988

Low Apgar scores and birth asphyxia. Misconceptions that promote undeserved negligence suits.

The temptation to specify cause-and-effect relationships in cases of neurologic handicap has created a number of misconceptions that have stimulated irresponsible malpractice litigation focusing on childbirth. Paradoxically, the number of such lawsuits is on the increase, even though obstetric and neonatal care has improved dramatically since Virginia Apgar introduced her scoring system in 1953. Nowadays, no evidence of intrapartum hypoxia is found in the majority of newborns who require resuscitation. Consequently, the value of using the Apgar score as an index for assessing asphyxia should be vigorously questioned. It should also be stressed that asphyxial damage may occur without respiratory depression. The recent proliferation of articles linking fetal scalp or cord blood evidence of metabolic acidosis to birth asphyxia threatens to create another legal booby trap. Although the development of fetal metabolic acidosis reflects oxygen deprivation, this fact should not be misconstrued to mean that any degree of oxygen deprivation can damage the brain. Available data make it quite clear that the fetus can sustain transient episodes of hypoxemia without ill effects. In those neonates born with low Apgar scores, cord blood gases should be measured to exclude hypoxemia. Securing such data can protect practitioners from subsequent legal inquiry. Routine determination of cord blood gases is not recommended, however, because a substantial number of newborns who are born acidotic have normal Apgar scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Apgar Score↗
PubMed2006

Clinical concepts of futility and ethically justified limits on neonatal care: a case presentation of an infant with Apgar scores of 0 at 1, 5, and 10 minutes.

Appropriate length of delivery room resuscitative efforts for infants born without signs of life is controversial. We present the case of a preterm infant with Apgar scores of 0 at 1, 5, and 10 minutes but with a recovered heartbeat at 15 minutes. Using the clinically relevant conceptions of the principle of futility, we examine the ethical justification for the successive decisions to initiate, continue, and ultimately limit care for this patient. This difficult case highlights the importance of understanding the ethical justification for clinical interventions that are made in the neonatal intensive care unit.

Apgar Score↗
PubMed1989

Epidural versus general anaesthesia for elective caesarean section. Effect on Apgar score and acid-base status of the newborn.

Elective Caesarean section deliveries over a 5-year period were studied to compare the effect of epidural block with general anaesthesia on the condition of the infant at birth. The Apgar score and umbilical arterial acid-base status were used as determinants of the latter. Epidural block was used in 139 (22.8%) mothers while 471 (77.2%) were performed under general anaesthesia. No babies in the epidural group were severely depressed (Apgar less than 4), compared with 6.2% in the general anaesthesia group. Only 4.3% of the epidural sections were moderately depressed (Apgar 4-6), compared with 15.4% of the others. These differences remained highly significant when infants of less than 2500 g were excluded, and when matched groups were compared. Mean umbilical arterial pH was similar within the two groups (pH 7.28), and was not consistent with asphyxia in almost 90% of the depressed infants. The findings suggest that general anaesthesia, rather than asphyxia or aortocaval compression, is responsible for most of the depressed infants born by elective Caesarean section. This may involve over 20% of babies delivered in this manner, so greater use of epidural block for elective Caesarean section is recommended. Further investigations are required to improve results with general anaesthesia.

Acid-Base Equilibrium↗
PubMed1989

[Cardiotocographic examination, pH values in the umbilical artery and the Apgar score in the diagnosis and prognosis in fetal and neonatal hypoxia].

The authors examined 91 neonates with one or several anamnestic signs of intra-partum hypoxia (cardiotocographic record, pH in blood of umbilical artery, Apgar score) and 65 neonates with a normal delivery. When evaluating signs of hypoxia, a very low correlation between the methods used was found. Neurological investigation of all children revealed significant differences in the incidence of neurological abnormalities between groups of hypoxic neonates (whatever method used) and the group of neonates without a history of hypoxia intra partum, but only in the second month. In the other age periods, when the children were subjected to neurological examination (6, 12 months), no differences were found in the frequency of neurological abnormalities between the group of "hypoxic" and normal children.

Apgar Score↗
PubMed1991

Effect of induction-delivery and uterine-delivery on apgar scoring of the newborn.

Very short or prolonged induction-delivery interval (i.e. less than 5 minutes or more than 15 minutes) and uterine-delivery interval of more than 90 seconds has a definite effect on the apgar scoring of a newborn especially when general anaesthesia is administered as compared to regional anaesthesia for caesarean section.

Anesthesia, General↗
PubMed1990

The effect of birth order in twins on fetal umbilical blood gas and apgar score.

Although recent reports have revealed no difference in perinatal mortality between a set of twins, more sensitive means other than perinatal mortality are necessary to evaluate differences in twins. This study examined differences between 34 twin pairs with respect to Apgar score, umbilical venous and arterial blood gas, and acid-base data. The parameters were measured in paired samples and compared with the paired t test and Fisher's exact probability test. The most coherent findings were a higher umbilical venous PO2 and umbilical arterial PO2 in twin A. Their differences were not due to the route of delivery, interval between twins, presentation or chorionicity. The data suggest that the second-born twin has potentially greater susceptibility to hypoxia and trauma.

Apgar Score↗
PubMed1997

Neurodevelopmental outcome in babies with a low Apgar score from Zimbabwe.

The early identification of neurological dysfunction in the neonatal period, the predictive value of single items of the neonatal neurological examination (NNE) adapted from Prechtl and the developmental outcome at 1 year of age in infants with a low Apgar score in Zimbabwe were studied. One hundred and sixty-five infants were examined with the NNE and 142 with the Bayley Scale of Infant Development (BSID) at 1 year of age. Twenty-three infants had cerebral palsy, ten had a motor delay or developmental delay, and four were mentally retarded. The NNE proved to be a sensitive instrument for detecting neurodevelopmental abnormality. Logistic regression analysis was used to investigate the relationship between the BSID and nine selected predictors from the NNE. This resulted in a correct classification of 94%. However, the number of false negatives was high. By using only the variability of movements and fixation as predictors the number of false negatives was reduced to one.

Apgar Score↗
PubMed1980

APGAR scores, respiratory distress syndrome and salbutamol.

In parallel studies at St Mary's Hospital, Portsmouth, in which women presenting in premature labour at 20 to 36 weeks' gestation were treated with salbutamol by mouth (208 women) or by parenteral administration (20 women), the prevention of low apgar scores was significant (P less than 0.01) if the dose-delivery interval was less than four hours and the prevention of respiratory distress syndrome (RDS) was significant (P less than 0.05) if the dose-delivery interval was less than three hours.

Albuterol↗
PubMed1988

Breech births in twin pregnancy: an analysis of Apgar score and perinatal mortality from a Nigerian sample.

Perinatal mortality (PNM) rates are reported for 146 twin-1 and 192 twin-2 breech births among 622 consecutive twin pairs delivered at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Stillbirths and infants with severe asphyxia (Apgar score 1-3) were recorded in significant proportions of both first and second twin breech infants. PNM rates were 13.7% twin-1, 18.8% twin-2; corrected PNM for infants weighing 2.0 kg or more, were 9.3% and 12.4% for twin-1 and twin-2, respectively. Twin specific breech PNM decreased with increasing birthweight of first and second twin to a low optimum in the weight group 2.5-2.9 kg, and thereafter rose for both first and second twin with birthweight 3.0 kg and above. Factors such as low birthweight, breech/breech presentation, breech extraction and retained second twin breech contributed significantly to the high PNM rates. More favorable PNM rates were recorded among a limited number of breech infants delivered by primary cesarean section for breech/breech or first twin breech presentations. A liberal approach to cesarean section delivery for breech twin births, and particularly for paired breech/breech presentations is strongly advocated.

Apgar Score↗