The World of Pregnancy

APGAR Score`s Parameters & Meaning

Being the first test made to your baby, the APGAR score is performed right after birth. The test was designed for a quick evaluation of the physical condition of the newborn after birth and to determine any immediate need for additional medical intervention.

APGAR Score

Although the APGAR score was developed even from 1952 by the anesthetist Virginia Apgar, you might have heard of this note as an acronym for activity, pulse, grimace, appearance and breathe.

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APGAR Parameters

The 5 parameters on which this test is based are: breathing, heart rate, reactivity to stimuli, muscle tone, skin appearance – parameters that will be noted with points from 0 to 2, each. By summing up these points, it`s obtained a score from – to 10, known as APGAR score. As already mentioned, it`s useful as, in the case of a score under 10, the appreciation of the score to be repeated at 5 or 10 minutes.

APGAR Score 2 1 0
Heart rate (pulse) Normal (over 100 beats/minute Under 100 beats/minute Absent (no pulse)
Breathing (rate & effort) Normal rate & effort, “healthy” crying Rare & irregular breathing, poor crying Absent (no crying)
Grimace (reflex to irritability) Sneezing, coughing or crying to stimuli Facial movements only when he`s stimulated Absent (no reactions to stimuli)
Activity (muscle tone) Active, spontaneous movements Arms & legs are flexed, with little movements No movements, inert tone
Appearance (skin color) Normally everywhere (hands & feet are pink Normal color (but hands & legs are purple Purple color (blue towards grey) everywhere

 

APGAR`s Score Meaning

In labor room, after establishing the score`s index, the immediate attitude of the neonatologist doctor would be reported at the given note.

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APGAR Score 8 – 10

This index is given to a newborn eutrophic (normal weight), healthy with good neonatal adaptation, who doesn`t need special care. This baby will be transported in the section of newborns for usual care:

  • Aspiration of secretions & discoloration of the upper airways.
  • Umbilical cord ligation.
  • Skin`s care: the remnants of amniotic fluid and blood are washed away with sterile compresses.
  • Prophylaxis of gonococcal ophthalmology: it`s performed routinely after birth and involves applying some drops in the conjunctival sac to prevent gonococcal eye infection if the mother has a gonococcal genital infection.
  • Checking the esophagus`s permeability.

APGAR Score 6 – 7

Newborns with this index show a more difficult adaptation to extrauterine life and might need special care:

  • Oxygen therapy.
  • Correction of a few biological deficits: acidosis, hypoglycemia, hypocalcemia, etc.

Note: The APGAR score will be repeated after 5 minutes.

APGAR Score ≤ 5

A newborn with an APGAR score of 5 or less shows a severe general state that requires further reanimation and intensive care, which will vary depending on the clinical situation of the baby: oxygen therapy, external cardiac massage, intubation, assisted ventilation, correction of hydro-electrolytic, metabolic or acido-basic disorders, etc.

Note: The APGAR score will be repeated after 5 minutes.

Understanding the APGAR Score

A child with a score of 8 or higher is generally considered to be in a healthy condition. However, a lower score doesn`t necessarily mean that your baby is unhealthy or abnormal. But it could mean that your baby needs immediate special care, like the aspiration of his airways to help him breathe, and then his condition may improve.

At 5 minutes after the birth of your child, the APGAR score is recalculated. If the score of your child was low and the baby`s condition hasn`t improve after receiving special care, the doctors and nurses will continue performing special care and monitor your baby closely. Some babies are born in certain conditions that require medical care, while other ones simply need more time to adapt to the extrauterine life. Most newborns with a low initial score manage to get better eventually.

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It`s good for future parents to pay attention to this score. This specific test was designed to help doctors to evaluate the general physical condition of the newborn to quickly determine if the baby needs special care or not. It wasn`t invented to predict the behavior, intellectual state or long-term health of the baby. Only very few children are noted with 10, and the children who are perfectly healthy usually have a lower score than usual, especially in the first minute after birth. Likewise, premature babies are those born through C-section can obtain a maximum of 9 point in the APGAR score.

If the doctor is worried about the newborn`s score, he`ll tell you and explain the child`s condition, which may be the causes, if any, as well as what treatment or care should be applied to your child. However, most children have a good health state, so just relax and enjoy the ride! So, instead of being focused on the number, try to focus on your baby.

Image courtesy of abclawcenters.com
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