Test del Recién Nacido (APGAR, Capurro y Silverman) – Fácil

Understanding the APGAR, Capurro, and Silverman Tests

Introduction to Gestational Age

• The speaker introduces the topic of gestational age and its importance in understanding newborn assessments.

• Gestational age is defined as the time measured in weeks from the first day of the last menstrual cycle until the current date.

• A normal pregnancy lasts between 37 to 42 weeks; births before 37 weeks are considered premature, while those after 42 weeks are termed post-term.

Trimesters of Pregnancy

• Pregnancy is divided into three trimesters for better management of potential complications such as malformations or risks of miscarriage.

• The first trimester spans from week 1 to week 13, the second from week 14 to week 27, and the third from week 28 to week 42.

• Understanding these divisions helps assess fetal development stages effectively.

APGAR Test Overview

• The APGAR test evaluates a newborn's health immediately after birth by assessing their adaptation to extrauterine life.

• It is conducted at one minute and five minutes post-birth; initial scores indicate how well the baby tolerated delivery.

• If low scores are observed (below a certain threshold), further evaluations can occur at ten and fifteen minutes.

Scoring Criteria for APGAR

• The test assesses five criteria: heart rate, respiratory effort, reflexes, muscle tone, and skin color. Each criterion is scored from 0 to 2.

• Scores range:

• 0–3 indicates severe depression,

• 4–6 indicates moderate depression,

• 7–10 indicates normal health status.

Example Application of APGAR

• An example illustrates scoring based on heart rate: less than 100 beats per minute earns one point; more than that earns two points.

• Similar scoring applies for respiratory effort—strong crying yields two points while weak or absent breathing results in lower scores.

Capurro Test for Estimating Gestational Age

Purpose of Capurro Test

• The Capurro test estimates a neonate's gestational age at birth using specific physical parameters.

Parameters Assessed in Capurro Test

• Five key parameters include:

• Ear shape,

• Size of mammary glands,

• Nipple formation,

• Skin texture,

• Plantar creases.

Understanding Gestational Age Assessment

Determining Gestational Age Using Scoring

• The assessment of a baby's characteristics helps determine gestational age, using a scoring system based on various physical attributes.

• For ear shape, 16 points are awarded if the upper edge is well-formed and curved, indicating maturity.

• Breast tissue size is scored between 5 to 10 millimeters for palpability, contributing additional points to the overall score.

• Skin texture is evaluated; a score of 10 points indicates slight oiliness with superficial peeling, suggesting developmental progress.

• A formula for calculating gestational age is introduced: Gestational Age = 240 + P/7, where P represents the total score from assessments.

Calculating and Interpreting Results

• After summing scores (56 in this example), the calculated gestational age results in approximately 37.1 weeks, translating to about 37 weeks plus a few days.

Evaluating Respiratory Function in Newborns

Silverman Test Overview

• The Silverman test assesses respiratory function based on five criteria to evaluate how well a newborn's lungs are adapting post-birth.

• A lower score indicates better respiratory function; higher scores suggest complications in gas exchange processes.

Key Parameters Assessed

• The parameters include nasal flaring (0–2 points), grunting sounds during breathing (audible or not), intercostal retractions, external retractions, and thoracoabdominal dissociation during respiration.

Practical Application of Tests

Case Study Evaluation

• In a hypothetical case study, scoring reveals mild respiratory distress with a total score of two points indicating potential issues that may resolve shortly after further evaluation.

Conclusion and Resources

• These tests are widely used across Latin America and globally due to their simplicity and effectiveness; they can be found readily available in delivery rooms or immediate care areas.