Apgar score in babies
Apgar score is an efficient method of evaluating newborns as they are born and is a tool which helps make decisions in the delivery room.
So, this chapter will explain what is Apgar score, what it is composed of, what it means and what is not the meaning of this score.
What does Apgar score in infants examine and when it is done?
In its classic form, Apgar score examines the combination of the following 5 components:
Infant’s heart rate – 2 points for a rhythm over 100 beats per minute, 1 point for less than 100 beats a minute and no score for absent heartbeat.
Infant’s breathing effort – 2 points for a newborn who’s breathing and crying normally, 1 point for a newborn with irregular breathing or that has difficulty in breathing and no score for a newborn who doesn’t breathe.
Muscle tension – 2 points for an active moving newborn, 1 point for a newborn that only bends it’s limbs and no score for a newborn that does not move.
Reaction to stimulation – Usually done by a suction tube at the tip of the nose or a light rub. 2 points for a newborn that cries, coughs or sneezes as a reaction to the stimuli, 1 point for a newborn that only twists his face and no score for a newborn who does not react.
Skin color – 2 points for a pinkish baby, 1 point for a newborn with pinkish colored body and blue limbs and no score for a blue or pale newborn.
Apgar score test is done for every newborn one minute after birth and then 5 minutes after birth. In case the 5 minute Apgar score is less than 7, another Apgar test can be performed every 5 minutes for additional 20 minutes.
What is the minimum and maximum postpartum Apgar score? What is a proper score?
By definition, even after a minute postpartum the extremities of the newborn’s are blue. Therefore, the maximum one minute Apgar score is 9. The minimum of course is 0. After 5 minutes the maximum Apgar score is 10 and the minimum is 0.
Just to let you know, I tried to put an 1 minute Apgar score of 10 to my middle child. The computer in the delivery room did not allow that.
In general, a proper one minute postpartum Apgar score is 7 and over.
What is the meaning of Apgar score?
Apgar score allows the medical team to make decisions after the birth. A newborn that have trouble breathing with a low heart rate could be treated by the midwife or the pediatrician by stimulation or heating in the delivery room.
On the other hand, when a newborn gets a normal Apgar score, he/she can be laid on the mother directly after the birth.
A very low Apgar score indicates a newborn in distress who should receive intensive treatment in the delivery room.
What does Apgar score not predict?
Apgar score does not necessarily predict any long-term outcomes of the newborn’s future.
Of course that a newborn that required prolonged resuscitation after birth and was hospitalized in neonatal ward for an extended period (and of course has a low score), could be at risk of future problems but this has nothing to do directly with Apgar score.
Remember that normal Apgar score is a good start to the baby’s arrival into the world. However, a low Apgar score does not necessarily mean the opposite.