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