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)

Apgar Scoring
Apgar Sign          2        1      0
Normal color all over (hands Normal color (but Bluish-gray or pale all
Appearance and feet are pink) hands and feet are over
(skin color) bluish)

Pulse Normal (above 100 beats per Below 100 beats per Absent
(heart rate) minute) minute (no pulse)

Pulls away, sneezes, coughs, Facial movement only Absent (no response
Grimace or cries with stimulation (grimace) with to stimulation)
("reflex irritability") stimulation

Activity Active, spontaneous Arms and legs flexed No movement,


(muscle tone) movement with little movement "floppy" tone

Respiration Normal rate and effort, good Slow or irregular Absent (no breathing)
(breathing rate and cry breathing, weak cry

effort)
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!

Reviewed by: Mary L. Gavin, MD

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