Apgar scores

Apgar Score

The Apgar Score is a quick test performed on a newborn baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process, and the 5-minute score tells the healthcare provider how well the baby is doing outside the mother's womb. The test was developed by Virginia Apgar, an American obstetrical anesthetist, in 1952.

Components of the Apgar Score

The Apgar score is based on five criteria, each of which is given a score between 0 and 2. The five criteria are:

Appearance (Skin Color)

1. • 0 points: Blue or pale all over
   • 1 point: Blue at extremities, body pink
   • 2 points: Completely pink

Pulse (Heart Rate)

1. • 0 points: No pulse
   • 1 point: Fewer than 100 beats per minute
   • 2 points: At least 100 beats per minute

Grimace Response (Reflexes)

1. • 0 points: No response to stimulation
   • 1 point: Grimace or feeble cry when stimulated
   • 2 points: Sneezing, coughing, or pulling away when stimulated

Activity (Muscle Tone)

1. • 0 points: Limp
   • 1 point: Some flexion of arms and legs
   • 2 points: Active motion

Respiration (Breathing Rate and Effort)

1. • 0 points: Not breathing
   • 1 point: Weak cry; may sound like whimpering, slow or irregular breathing
   • 2 points: Good, strong cry; normal rate and effort of breathing

The scores for each of these five criteria are then summed up to obtain a total score ranging from 0 to 10.

Interpretation of the Apgar Score

• A score of 7 to 10 is generally normal and indicates that the newborn is in good health.
• A score of 4 to 6 might require some resuscitative measures and close monitoring.
• A score of 3 or below is critically low, indicating the need for immediate resuscitation.

History and Development

The Apgar score was developed by Virginia Apgar in 1952 as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth. It has since become a standard practice in hospitals worldwide.

Clinical Significance

The Apgar score is a useful tool for determining the immediate health of a newborn and the need for any urgent medical intervention. However, it is not designed to predict long-term health issues or outcomes.

Limitations

While the Apgar score is a valuable initial assessment tool, it has limitations. It does not predict future health, behavior, or intelligence. It is also not used to diagnose any specific conditions.

Also see

• Virginia Apgar
• Neonatal care
• Newborn resuscitation
• Pediatric assessment

Resources

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Source: Data courtesy of the U.S. National Library of Medicine. Since the data might have changed, please query MeSH on Apgar scores for any updates.

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