Apgar Score

In Cerebral Palsy, Medical on September 25, 2008 at 5:48 am

Dr. Virginia Apgar

Apgar Score, a method of early test developed by anesthesiologist Virginia Apgar in 1952 and now used in modern hospitals worldwide , rates a baby’s appearance, pulse, responsiveness, muscle activity, and breathing with a number between zero and 2 (2 being the strongest rating). The numbers are totaled, and 10 is considered a perfect score.


It’s easy to remember what’s being tested by thinking of the letters in the name “APGAR”: Activity, Pulse, Grimace, Appearance, and Respiration. Here’s how they’re used to rate your baby:

  1. Heart Rate:
    a. Absent heartbeat = 0.
    b. Slow heartbeat (less than 100 beats per minute) = 1.
    c. Adequate heartbeat (more than 100 beats per minute) = 2.
  2. Respiration:
    a. Not breathing = 0.
    b. Weak cry, irregular breathing = 1.
    c. Strong cry = 2.
  3. Muscle Tone:
    a. Limp, flaccid = 0.
    b. Some flexing or bending = 1.
    c. Active motion = 2.
  4. Response to Stimulation (also called Reflex Irritability):
    a. No response = 0.
    b. Grimace = 1.
    c. Vigorous cry or withdrawal = 2.
  5. Color:
    a. Pale or blue = 0.
    b. Normal color body but blue extremities = 1.
    c. Normal color = 2.

The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby’s condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. However, a lower score doesn’t necessarily mean that your baby is unhealthy or abnormal. But it may mean that your baby simply needs some special immediate care, such as suctioning of the airways or oxygen to help him or her breathe, after which your baby may improve.

At 5 minutes after birth, the Apgar score is recalculated, and if your baby’s score hasn’t improved to 7 or greater, or there are other concerns, the doctors and nurses may continue any necessary medical care and will closely monitor your baby. Some babies are born with heart or lung conditions or other problems that require extra medical care; others just take a little longer than usual to adjust to life outside the womb. Most newborns with initial Apgar scores of less than 7 will eventually do just fine.


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