What is the Apgar score?

The very first test given to your newborn, the Apgar score occurs right
after your baby's birth in the delivery or birthing room. The test was
designed to quickly evaluate a newborn's physical condition after
delivery and to determine any immediate need for extra medical or
emergency care.
Although the Apgar score was developed in 1952 by an anaesthesiologist
named Virginia Apgar, you may have also heard it referred to as an
acronym for: Activity, Pulse, Grimace, Appearance, and Respiration.
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.
Five factors are used to evaluate the baby's condition and each factor
is scored on a scale of 0 to 2, with 2 being the best score:
Activity and muscle tone
Pulse (heart rate)
Grimace response (medically known as "reflex irritability")
Appearance (skin coloration)
Respiration (breathing rate and effort)
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.
|
Apgar Scoring
|
|
Apgar Sign
|
2
|
1
|
0
|
|
Heart Rate
(pulse)
|
Normal (above 100 beats per minute)
|
Below 100 beats per minute
|
Absent
(no pulse)
|
|
Breathing
(rate and effort)
|
Normal rate and effort, good cry
|
Slow or irregular breathing, weak cry
|
Absent (no breathing)
|
|
Grimace (responsiveness or "reflex irritability")
|
Pulls away, sneezes, or coughs with
stimulation
|
Facial movement only (grimace) with
stimulation
|
Absent (no response to stimulation)
|
|
Activity
(muscle tone)
|
Active, spontaneous movement
|
Arms and legs flexed with little movement
|
No movement, "floppy" tone
|
|
Appearance
(skin coloration)
|
Normal colour all over (hands and feet are
pink)
|
Normal colour (but hands and feet are
bluish)
|
Bluish-gray or pale all over
|
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.
It's important for new parents to keep their baby's Apgar score in
perspective. The test was designed to help health care providers assess
a newborn's overall physical condition so that they could quickly
determine whether the baby needed immediate medical care. It was not
designed to predict a baby's long-term health, behaviour, intellectual
status, or outcome. Few babies score a perfect 10, and perfectly
healthy babies sometimes have a lower-than-usual score, especially in
the first few minutes after birth.
Keep in mind that a slightly low Apgar score (especially at 1 minute)
is normal for some newborns, especially those born after a high-risk
pregnancy, caesarean section, or a complicated labour and delivery.
Lower Apgar scores are also seen in premature babies, who usually have
less muscle tone than full-term newborns and who, in many cases, will
require extra monitoring and breathing assistance because of their
immature lungs.
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. For
the most part, though, most babies do very well, so relax and enjoy the
moment!
Source: http://www.kidshealth.org/parent/pregnancy_newborn/pregnancy/apgar.html