What does apgar mean

Apgar score: MedlinePlus Medical Encyclopedia

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Apgar is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb.

In rare cases, the test will be done 10 minutes after birth.

Virginia Apgar, MD (1909-1974) introduced the Apgar score in 1952.

The Apgar test is done by a doctor, midwife, or nurse. The provider examines the baby's:

• Breathing effort
• Heart rate
• Muscle tone
• Reflexes
• Skin color

Each category is scored with 0, 1, or 2, depending on the observed condition.

Breathing effort:

• If the infant is not breathing, the respiratory score is 0.
• If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
• If the infant cries well, the respiratory score is 2.

Heart rate is evaluated by stethoscope. This is the most important assessment:

• If there is no heartbeat, the infant scores 0 for heart rate.
• If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
• If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.

Muscle tone:

• If muscles are loose and floppy, the infant scores 0 for muscle tone.
• If there is some muscle tone, the infant scores 1.
• If there is active motion, the infant scores 2 for muscle tone.

Grimace response or reflex irritability is a term describing response to stimulation, such as a mild pinch:

• If there is no reaction, the infant scores 0 for reflex irritability.
• If there is grimacing, the infant scores 1 for reflex irritability.
• If there is grimacing and a cough, sneeze, or vigorous cry, the infant scores 2 for reflex irritability.

Skin color:

• If the skin color is pale blue, the infant scores 0 for color.
• If the body is pink and the extremities are blue, the infant scores 1 for color.
• If the entire body is pink, the infant scores 2 for color.

This test is done to determine whether a newborn needs help breathing or is having heart trouble.

The Apgar score is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.

A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.

Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjust outside the mother's womb.

Most of the time a low Apgar score is caused by:

• Difficult birth
• C-section
• Fluid in the baby's airway

A baby with a low Apgar score may need:

• Oxygen and clearing out the airway to help with breathing
• Physical stimulation to get the heart beating at a healthy rate

Most of the time, a low score at 1 minute is near-normal by 5 minutes.

A lower Apgar score does not mean a child will have serious or long-term health problems. The Apgar score is not designed to predict the future health of the child.

Newborn scoring; Delivery - Apgar

• Infant care following delivery
• Newborn test

Arulkumaran S. Fetal surveillance in labor. In: Arulkumaran SS, Robson MS, eds. Munro Kerr's Operative Obstetrics. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 9.

Goyal NK. The newborn infant. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 113.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What Is the Apgar Score?

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What Is the Apgar Score?

The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed.

The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby's condition, the test may be given again.

What Does "Apgar" Mean?

Apgar stands for "Appearance, Pulse, Grimace, Activity, and Respiration. "

In the test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score:

1. Appearance (skin color)
2. Pulse (heart rate)
3. Grimace response (reflexes)
4. Activity (muscle tone)
5. Respiration (breathing rate and effort)

Doctors, midwives, or nurses add up these five factors for the Apgar score. Scores are between 10 and 0. Ten is the highest score possible, but few babies get it. That's because most babies' hands and feet remain blue until they have warmed up.

Apgar Scoring

What Does My Baby's Score Mean?

A baby who scores a 7 or above on the test is considered in good health. A lower score does not mean that your baby is unhealthy. It means that your baby may need some immediate medical care, such as suctioning of the airways or oxygen to help him or her breathe better. Perfectly healthy babies sometimes have a lower-than-usual score, especially in the first few minutes after birth.

A slightly low score (especially at 1 minute) is common, especially in babies born:

• after a high-risk pregnancy
• through a C-section
• after a complicated labor and delivery
• prematurely

At 5 minutes after birth, the test is given again. If a baby's score was low at first and hasn't improved, or there are other concerns, the doctors and nurses will continue any necessary medical care. The baby will be monitored closely.

What if My Baby Has a Low Score?

Many babies with low scores are perfectly healthy and do just fine after adjusting to life outside the womb.

If your doctor or midwife is concerned about your baby's score, he or she will let you know and will explain how your baby is doing, what might be causing problems (if any), and what care is being given.

What Else Do I Need to Know?

This test was not designed to predict a baby's long-term health, behavior, intelligence, personality, or outcome. It was designed to help health care providers tell a newborn's overall physical condition so that they could quickly decide whether the baby needed immediate medical care.

With time to adjust to the new environment and with any necessary medical care, most babies do very well. So rather than focusing on a number, just enjoy your new baby!

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Apgar score - articles from specialists of the clinic "Mother and Child"

first evaluation of the baby

As soon as the child is born, doctors immediately assess his condition and physical development. But not only weight and height are measured for the baby, there are other characteristics by which one can judge how healthy the child is. To do this, use a special scale proposed by the anesthesiologist Virginia Apgar and named after her.

why is it needed

The Apgar score is used to determine which children need more attention. According to this scale, the health status of each newborn is assessed on five indicators: heart rate, respiration, muscle tone, reflexes and skin color of the baby.

The Apgar score, whether it be high or low, is not a diagnosis. This is a signal for the doctor about what measures are now needed or, conversely, the child does not need. Depending on the results of the assessment, an additional examination may be prescribed: blood tests, urine tests, a study for intrauterine infections, ultrasound, neurosonography. And after that, it is decided what to do next - to observe or treat the child.

how to test

During examination, each symptom (heart rate, respiration, muscle tone, reflexes, and skin color) is given 0, 1, or 2 points. A score of 2 points in the delivery room is considered the highest and means that the sign is pronounced, 1 point - weakly expressed, 0 points - the sign is absent. The child is evaluated on the Apgar scale at the 1st and 5th minutes of life, so there are always two scores, for example, 8/9 points or 9/10 points. Children rarely score the maximum 10 points in the first minute of life, and usually the first score is always lower than the second. But the second assessment can just be equal to 10 points.

evaluation criteria

counting points

Children who score between 7 and 10 are considered to be in good condition and usually require only routine care. Those who score between 4 and 6 are in fair condition and may only need some resuscitation. Immediate life-saving assistance is needed for those who score below 4.

let's be objective

In general, the Apgar score, although it is set according to objective criteria, still does not give an absolutely accurate forecast of the child's health in the future. It cannot be unequivocally said that a newborn who was given a 9or 10 Apgar scores, healthier than someone who got only 7 points. This only means that in the first case the baby breathes normally, he has pink skin and mucous membranes, he screams loudly enough, he has well-defined reflexes. And in the second case, one or two signs are less pronounced: for example, in the first minute the skin of the extremities is bluish, not pink, because the circulatory system takes about 5 minutes to get it working, or a healthy newborn loses points because he screams quietly in the first minutes life.

what is important

As already mentioned, the first Apgar score is always lower than the second. In most newborns, the condition 1 minute after birth is estimated at 7-8 points on the Apgar scale, and after 5 minutes - at 8-10 points. And this suggests that the child was born in a satisfactory (normal) condition. If the Apgar score at the 1st minute is low, then the positive dynamics by the 5th minute will be important. If the points increase by 2 or more by the 5th minute, then most likely the prognosis for health will be favorable. If, 5 minutes after birth, the Apgar score does not exceed 6 points, it will be necessary to conduct intensive therapy or continue resuscitation. So the main task of the Apgar scale is a quick assessment of whether a child needs medical help and how much.

Whatever the Apgar score, the development of a child largely depends on love, care and upbringing in the family. So parental attention will always help the baby achieve the highest marks in life!

The maximum score of 10 in the first minute of life is rare for children, and usually the first score is always lower than the second. But the second score can just be equal to 10 points

With a low Apgar score at the 1st minute of a baby’s life, positive dynamics is extremely important - an increase of 2 or more points by the 5th minute of life

Most newborns have an Apgar score of 7–8 1 minute after birth and 8–10 Apgar scores 5 minutes later

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A neonatologist from St.

What do the scores on the scale say and whether it is possible to judge the future development of the baby on the basis of them? "clinical status") in the first minutes of life. It was proposed by the American anesthesiologist Virginia Apgar almost 70 years ago, but remains relevant to this day.