Factors affecting the differentiation of the apgar score and the biochemical correlation of fetal well-being – A prospective observational clinical study
Article Category: Praca Oryginalna/Original Article
Publicado en línea: 04 oct 2018
Páginas: 238 - 246
Recibido: 07 feb 2018
Aceptado: 23 may 2018
DOI: https://doi.org/10.34763/devperiodmed.20182203.238246
© 2018 Maria Kostro, Natalia Jacyna, Ewa Głuszczak-Idziakowska, Katarzyna Sułek-Kamas, Grzegorz Jakiel, Maria Wilińska, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
The purpose of the study was to identify the features of both the labor and the assisting physicians when evaluating the newborn according to the Apgar score and how these correlate with the biochemical markers of fetal well-being in order to make the Apgar score more objective.
Material and methods
A prospective observational clinical study conducted in a 3rd reference level center between 1st April 2014 and 31st March 2015. The study enrolled 17 neonatologists and 1527 term newborns.
Results
The Apgar score is highest after natural vaginal delivery, lower after instrumental labor (p <0.001). The pH of the umbilical cord blood and lactate concentration correlate better with a high score than with a lowered one. The young age of a physician does not reduce Apgar score reliability. There were no differences in Apgar assessment according to physicians’ training and the time of labor. There were no correlations between abnormalities in postnatal central nervous system ultrasound and the Apgar score.
Conclusion
Biochemical tests of umbilical cord blood significantly increase the Apgar score reliability.