Assessing birth asphyxia using strictly observational signs, the ARC and AC scores versus Apgar score

Abstract

The Apgar Scoring system is the sole assessment tool for newborn asphyxia,but the Apgar scoring system has many limitations as it does not assess conditions before and after delivery, that might trigger asphyxia. Moreover, the score combine subjective and objective signs as well as observations and measurements which need resources, skills and time that are not always sufficiently available to out health workers and health facilities. So far, there is no other alternative score system, convenient to health workers. The AC score, a simple tool along with the ARC score, strictly observational ,developed by Dr Sultan Omar Sultan was pre-tested at St Francis Hospital Ifakara in 2008 , then tested on 340 newborns in Temeke Hospital and Mnazi Mmoja Hospital. It was found be more sensitive, more specific and more reliable and ultimately easy to use for newborn asphyxia assessment (P:0,03<0,05) using Chi square test) compared to the Apgar Score. The specificity, sensitivity and reliability of the ARC and AC score was 100%. There was no significant difference between the results of ARC and AC scores (similar results).Considering the simplicity of the AC score (2 variables compared to 3 in ARC score), it was suggested, with confidence that the AC score is a valid alternative and easy tool in asphyxia assessment at birth that can be utilized both at health facility and at household by any trained health worker.

KEY WORDS: Assessment, Asphyxia, Observation, Apgar Score