Ans is 'a' i.e., APGAR at 7 min indicates neonatal moality depression Later times APGAR score (after 5 minutes) indicates about long term neurological damage (not neonatal moality) Interpretation ofAPGAR Score The test is generally done at one and five minutes after bih, and may be repeated later if the score is and remains low. Scores 3 and below are generally regarded as critically low, 4 to 6 fairly low, and 7 to I 0 generally normal. o A low score on the one-minute test may show that the neonate requires medical attention (e.g. resuscitation) but is not necessarily an indication that there will be long-term problems, paicularly if there is an improvement by the stage of the five-minute test. If the Apgar score remains below 3 at later times such as 10, 15 or 30 mintues, there is a risk that the child will suffer longer-term neurological damage. There is also a small but significant increase of the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long-term predicitions on a child's health. CO2 transpo across placenta o CO2 is cleared by placenta by simple diffusion. CO2 is produced abundantly in the fetus, and the PCO2 of fetal blood is higher than maternal blood. CO2 therefore diffuses from fetal blood, through the placenta, into the maternal circulation, and is disposed by expiration from mother's lung. Anaerobic metabolism causes acidemia due to lactate (lactic acid) production o Anoxic perfusion causes an increase in glucose consumption which is more than two fold higher than that seen in the oxygenated perfusion, resulting finally in placental uptake of glucose not only from the maternal but also from the fetal circulation. o Lactate production is increased during the anoxic perfusion, while the final tissue energy value lies between the values observed for fresh tissue and for the oxygenated perfusion. The shift to anerobic metabolism shown by placental tissue in anoxic conditions enables continued functioning of the tissue over the 2-h perfusion period but it appear that under anoxic conditions the tissue may incur an energy debt not observed in oxygenated perfusions.