Apgar score is the first medical evaluation of infants and occurs in the first minute of life, and then is repeated after 5 minutes from expulsion.
Apgar score was named after Virginia Apgar, who first proposed, in 1953, this score as a way to evaluate, in measurable and quantitative terms the health of the newborn. Apgar score is used today in all modern hospitals.
Baby’s medical evaluation is done based on 5 parameters, which are: breathing, heart rate, reactivity to stimuli, musclar tonus and skin appearance. These parameters will be marked with a note from 0 to 2, each, summing in total a score from 0 to 10, called the Apgar score.
Muscular tonus (activity):
It is estimated based on active and passive movements:
- 0 – Muscles are flaccid;
- 1 – Some flexion movements of the extremities;
- 2 – Present active movements, muscular tonus is good.
Heart rate (pulse):
- 0 – Absence of heart beat;
- 1 – Less than 100 heart beats per minute;
- 2 – More than 100 heart beats per minute.
Reflex excitability (grimace):
Reflex excitability or reflectivity, is the response of the new born to external stimuli, is estimated by response that appear when the probe is placed into nasal cavity to release the airways:
- 0 – Does not react;
- 1 – Makes a grimace;
- 2 – Screams, coughs or sneezes.
Skin color (appearance):
Skin color is important because it reveals the degree of oxygenation of the blood:
Breathing and screaming (breathing):
It is estimated the occurrence of spontaneous breathing, reflected by a scream or cry and the presence of vigorous respiratory movements:
- 0 – Absence of breathing;
- 1 – irregular breathing movements, weak cry;
- 2 – Regular breathing movements, screaming or crying vigorously.
Making a Agpar score of a newborn at one minute after the expulsion,, will help the doctor to determine if the baby requires urgent medical assistance.
If the infant accumulated a Apgar score between 7 and 10, means that it is healthy and require only standard care.
A Apgar score located between 4 and 6 indicate that the infant has trouble breathing. This situation can be remedied by massage and oxygen.
If a baby accumulates a scor under 3 that, shows a poor general condition and requires intensive care. However, keep in mind that a low Apgar score obtained in the first minute of life, does not mean that the infant will not feel better over time. Children who are born prematurely or by cesarean section usually record a lower Apgar score than the baby born naturally.
Index obtained from the assessment made at 60 seconds after the expulsion, is reassessed after 5 minutes, to see the progress made by the baby or if he had respond positively to any type of intervention, of which he has been subjected. A normal Apgar score for the 5 minutes should be between 7 and 10. However, if the infant register a Apgar score below 6, at the second evaluation, the child may need medical intervention and the doctor will determine the next steps.