Diagnostics
This examination is performed one, five and ten minutes after birth and the points of each category are added up. The normal score is about 9-10 points, while 5-8 points indicate a state of depression or mild asphyxia. Asphyxia is a threatening state of suffocation caused by the decreasing oxygen content in the blood.
At the same time, the carbon dioxide content in the blood increases, which causes the brain to feel suffocated, because there are certain areas of the brain stem that can measure the carbon dioxide content in the cerebrospinal fluid (liquor). If the infant reaches less than 5 points according to the APGAR scheme, there is acute danger to the life of the infant. For premature babies, however, the APGAR index is only of limited use, because these children are not yet sufficiently developed for life outside the womb and therefore require special treatment, i.e. without special measures, some of them would not be viable. This index, which is designed for babies born regularly, is therefore not comparable for premature babies.
Possible therapeutic measures
If the infant reaches less than 5 points according to the APGAR scheme, it is a life-threatening condition. Emergency measures such as resuscitation and/or artificial respiration must be initiated immediately, not only to save the life but also to prevent permanent damage, especially to the brain, because this organ is particularly sensitive to oxygen deficiency. Emergency surgery must also be initiated immediately if esophageal or rectal atresia is present. Cleft lips and palate can also be corrected by surgery, so that nothing is noticeable afterwards.
Vitamin K Prophylaxis
An important prophylaxis is the administration of vitamin K. Each infant receives 3 times 2 mg. This vitamin is needed for blood coagulation, i.e. the formation of clots. The infant usually does not have enough of it because there is too little in breast milk, the liver is not yet fully developed and the intestines are not yet populated by bacteria that can produce vitamin K. In addition, vitamin K prophylaxis lowers the incidence of the disease Morbus haemorrhagicus neonatorum. This means an increased bleeding tendency of the infant.
