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APGAR SCORE

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APGAR SCORE

The Apgar score is an assessment of the physical condition of new-borns in their first moment of life.

  • This assessment helps health practitioners in their decision making so they could quickly tell if a new born baby needed immediate medical care.
  • An anesthesiologist at the New York Presbyterian Hospital named Dr. Virginia Apgar discovered the score in 1952 to assess the health and vital signs of a newborn baby.
  • The test is given at 1 minute after birth and again at 5 minutes after birth. In cases where there are still some concerns about the baby’s condition, the test may be given again.
  • The score obtained at the 1-minute determines how well the baby tolerated the birthing process and the 5-minute score tells of how the baby is doing outside the mother’s womb.

HOW DOES IT WORK?

  • The Apgar score is calculated by evaluating the baby on five criteria.
  • Each criterion receives a score between 0,1,2 depending on the observed condition
  • The values obtained from each is then summed up. The resulting Apgar score ranges from 0-10.
  • The five criteria are Appearance, Pulse, Grimace, Activity, Respiration

APPEARANCE (Skin color)

  • If the skin color appears blue, bluish-gray or pale, the infant is scored 0 for color
  • If the body is pink but the extremities(hand and feet) are blue, the infant is scored 1 for color
  • If the entire body appears normal and is pink, the infant scores 2 for color

PULSE (heart rate)

  • If there is no pulse, the infant scores 0 for pulse
  • If pulse is less than 100 beats per minute, the infant is scored 1 for pulse
  • If the pulse is greater than 100 beats per minute, the infant is scored 2 for pulse

GRIMACE (reflex response) – how the baby responds to stimulation like a mild pinch

  • if there is no response or reaction, the infant is scored 0 for grimace
  • if there is a facial movement only, the infant is scored 1 for grimace
  • if there is a cough, sneeze, cry, or pulling away, the infant is scored 2 for grimace

ACTIVITY (muscle tone)

  • if the muscles are loose and floppy (no movement), the infant is scored 0 for activity
  • if the arms and legs are flexed with little movement, the infant is scored 1 for activity
  • if there is an active spontaneous movement, the infant is scored 2 for activity

RESPIRATION (breathing)

  • if there is an absence respiration, the infant is scored 0 for respiration
  • if the respirations are slow and irregular with weak cry, the infant is scored 1 for respiration
  • if the respiration is normal with a good, strong cry, the infant is scored 2 for respiration

WHAT DOES THE SCORE MEAN?

The first Apgar score gives the health practitioners a clue in deciding if the baby needs immediate medical attention. A score between 7 and 10 is good and means that your baby is in good shape.

If the score is between 4-6, it means that the baby may need help with breathing, such as suctioning the airways, massaging, or giving him oxygen to help such baby breathe better.

If the score is 3 or less, the baby may need immediate resuscitative measure. However, a slightly low score is common in babies born prematurely, with complicated deliveries or through a C-section.

 

The second score helps the health practitioner to know how well the baby is progressing and whether the baby has responded to any previous medical intervention. A score above 7 is considered normal. If the score is still low at this point, the baby may need medical help and will be monitored closely