APGAR Score Silverman – Andersen Index – Neonatal Respiratory Distress

Grading

1 min scoring – how well the baby tolerated the birthing process

5-min scoring – how well the baby is doing outside the mother’s
womb

Interpretation Grading:

0-3 SEVERLY DEPRESSED 0 = No respiratory distress

4-6 MODERATELY DEPRESSED 4-6 = Moderate Distress

7-10 GOOD/ HEALTHY 7-10 = Severe Distress

I. Problem Related to Maturity

A. Full term infant: delivered 37 to 40 weeks of
development
B. Preterm Infant: before 37 wks, weight less than 5 ½
pounds (2.5 kg)
How to determine the maturity of newborn? r. History of spontaneous (i.e, miscarriage) or surgical
abortion
a. Physical finding’s (Ballard’s Maturity Testing) s. Unwanted or wanted pregnancies
b. Neurologic findings that reveal gestational age t. Unmarried mothers
c. Mother’s report of LMP u. Women with abnormal amounts of amniotic fluids
d. Sonographic estimation of gestation age v. Mental status of women
Etiology Characteristics of a Pre-term Infant
a. Low socio economic a. Very small and appear scrawny
b. Poor nutritional status (low bmi) b. Have a proportionate large head in relation to the
c. Lack of prenatal care body with scant hair
d. Multiple pregnancy (twins, triplets) c. Skin: bright pink, smooth, and shiny, with small
e. Previous birth blood vessels clearly visible underneath the thin
f. Race epidermis
g. Use of tobacco, cocaine, and excessive alcohol during d. Fine lanugo- abundant over the body but Is sparse,
pregnancy fine, and fuzzy on the head
h. Age of mother (younger than 18 years old/ older than 35 e. Ear cartilage- soft & pliable
y/o) f. Soles and palms – minimum creases
i. Order of birth ( 1st and beyond 4th pregnancy) g. Bones of the skull and ribs – feel soft
j. Maternal height and weight h. Eyes may be fused
k. Closely spaced pregnancies (6 mos or less) i. Sleeps most of the time
l. Abnormalities of mother’s reproductive system j. Inactive and listless
(intrauterine septum) k. Underdeveloped breast tissue
m. Infections (UTI; Intrauterine inflammation/infection) l. Male infants- few scrotal rugae, testes are
n. OB Complications (premature rupture undescended
membranes/separation of the placenta/ decidual bleeding) m. Females- labia minora and clitoris are prominent
o. Early Induction of labor n. Extremities – maintain an attitude of extension and
p. Elective c-section delivery remain in any position in which they are placed
q. Type of work and physical activity of mother (stressful o.
conditions, hard labor, and long hours)