Introduction
APGAR stands for:
- Activity
- Pulse
- Grimace
- Appearance
- Respiration
Co-incidentally this is also the exact last name of the anaesthetist who developed the score in the 1950s – Virginia Apgar.
The score is assessed immediately after birth in the delivery room and is a screening tool to assess for the need for any emergency medical intervention.
It is a predictor of the need for urgent immediate care, but is not a predictor of any long term health defects.
APGAR birth prognosis score
Score | 0 | 1 | 2 |
Activity (muscle tone) | Absent | Arms and legs flexed | Active movement |
Pulse | Absent | Below 100 bpm | Above 100 bpm |
Grimace (reflex irritability) | Flaccid | Some flexion of extremities | Active motion (sneeze, cough, pull away) |
Appearance (skin colour) | Blue, pale | Body pink, extremities blue | Completely pink |
Respiration | Absent | Slow, irregular | Vigorous cry |
The test is performed at one and five minutes after birth.
Flow Chart
Results
Scores 3 and below are generally regarded as critically low, 4 to 6 fairly low, and 7 to 10 generally normal.
A low score does not necessarily mean that there is something critically wrong with the newborn – but it prompts further medical assessment and intervention. For example – a low APGAR score may be the result of residual fluid in the airway, and a simple suction of the airways may be enough to restore the score to the ‘normal’ range.
Typically lower scores are seen in:
- Premature deliveries – typically lower muscle tone and less developed lung function
- High-risk pregnancies
- Caesarean section
- Complicated deliveries
