APGAR SCORING

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.

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:
o Appearance (skin coloration)
o Pulse (heart rate)
o Grimace response (medically known as "reflex irritability")
o Activity (muscle tone)
o Respiration (breathing rate and effort)

Apgar Sign 2 1 0
Normal color all Normal color (but Bluish-gray or pale
Appearance (skin over (hands and hands and feet all over
color) feet are pink) are bluish)
Normal (above 100 Below 100 beats Absent (no pulse)
Pulse (heart rate) beats per minute) per minute
Pulls away, Facial movement Absent (no
Grimace ("reflex sneezes, coughs, or only (grimace) response to
irritability") cries with with stimulation stimulation)
stimulation

Active, Arms and legs No movement,

Activity (muscle spontaneous flexed with little "floppy" tone
tone) movement movement

Respiration Normal rate and Slow or irregular Absent (no

(breathing rate effort, good cry breathing, weak breathing)
and effort) cry

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.