APGAR Scoring Maternity

What is APGAR? an easy and quick assessment tool used to assess the status of a
newborn baby after birth. The word “APGAR” is named after its creator, Virginia Apgar,
but it also serves as a mnemonic for assessing newborns.

APGAR stands for:

Appearance (skin color)

Pulse (heart rate)

Grimace (reflex irritability)

Activity (muscle tone)

Respiration (effort)

*APGAR scoring is performed at 1 minute and 5 minutes after birth and may be
reassessed at 10 minutes (5 minutes later) after birth, if the score is 6 or less.

Each category is scored 0-2 and added up for a score 0-10. The higher the score the
better the baby is doing. It is rare to have a perfect 10 because most babies have
acrocyanosis after birth where the feet and hands will be blue.

Appearance:

● 0: pallor or blue all over

● 1: body pink but extremities blue (hands and feet)…acrocyanosis
● 2: Body and extremities all pink

Pulse:

● 0: absent
● 1: <100 bpm
● 2: >100 bpm

Grimace:

● 0: not response to stimulation

● 1: grimace to stimulation (no cry)
● 2: cry and active movement to stimulation

Activity:

● 0: none, flaccid
 ● 1: some flexion of arms and legs,
● 2: arms and leg flexed

Respiratory:

● 0: absent
● 1: weak cry, irregular
● 2: strong cry

Interventions based on the APGAR Score:

Score 7-10: no interventions, baby doing good just needs routine post-delivery care
Score 4-6: some resuscitation assistance required. Oxygen, suction…. stimulate the
baby, rub baby’s back
Score 0-3: need full resuscitation