There are several tests scheduled for the newborns to assess how healthy the baby is and if any immediate medical attention is required. Among these tests, the very first test performed on a newborn immediately after delivery, most probably in the labor room itself is called – the Apgar test.
The Apgar test was developed by Dr. Virginia Apgar, who was an anesthesiologist. What is it and why it is performed? Read on to know all about this test.
In This Article
- Apgar Test: What Is It?
- What Is An Apgar Score Chart?
- What Do Apgar Scores Indicate?
- Limitations Of The Apgar Score
Apgar Test: What Is It?
The APGAR is a scoring system, in which the first general evaluation of the health of the baby is recorded. The Apgar test shows the doctors how healthy the baby is during the first moments of his life and if the baby requires any medical attention — and if he does, how soon the baby needs it. Apgar is an acronym.
- A-Appearance, which refers to the color of the baby’s skin
- P-Pulse, which refers to the heart rate of the baby
- G-Grimace response, which medically refers to reflex irritability, is a term describing the response of the baby to the stimulations, such as a mild pinch
- A-Activity, muscle tone
- R-Respiration, which refers to breathing effort and rate of breathing
The Apgar test is generally done twice
- The first test is done one minute right after the baby’s birth
- After five minutes of the baby’s birth, the second test is performed. Even if the first test shows a low score, most of the time, by the second test is taken the scores will be normal
If the Apgar score during the first two tests shows abnormal reading, the test is repeated 10 minutes after the baby’s birth to confirm the reading.
What Is An Apgar Score Chart?
The score ranges from 0-2 for each category. The total number of categories (as explained above) is 5. Therefore, the total score taken is out of ten. The test is simple and is performed by a nurse or doctor. Higher the score, the healthier the baby is.
However, babies seldom get a ten out of ten scores as the baby’s skin always has a blue tinge during birth time. The scores of 7, 8, or 9 are considered normal. As the score goes below six (1 to 6), the baby needs medical attention. The lower the score, the faster the medical attention.
Let us see how the scoring is being done. The table below will help to understand the scoring rules better.
| ‘The Apgar Score’ For Newborns | |||||||
|---|---|---|---|---|---|---|---|
| Category | Score 2 | Score 1 | Score 0 | ||||
| Activity (evaluating the movement of the baby) | The baby is very active with unprompted movements | Arms and legs are flexed but with little movement | Loose and Floppy tone with no movements | ||||
| Pulse(Evaluating the heartbeat with a stethoscope) | More than 100 heartbeats per minute | Less than 100 beats per minute | No heartbeat | ||||
| Grimace (Evaluating how the baby responds to stimulation like a light pinch) | The baby sneezes or coughs and tries to pull away, and cries vigorously when lightly pinched. | Only grimace when lightly pinched. No other reflex actions will happen. | No response at all to any kind of stimulation | ||||
| Appearance (Evaluating the skin color of the baby) | Normal colored body.Pinkish feet and hands | Normal colored body. There is a bluish tinge on the feet and hands | Skin all over the body is pale or has a bluish-gray tinge | ||||
| Respiration(Evaluating the breathing rate and breathing effort of the baby) | Regular breathing and the baby will cry strongly | Slow or irregular respiration and the baby’s cry will be weak, indicating high breathing effort. | The infant is not breathing | ||||
What Do Apgar Scores Indicate?
If the baby gets a low score on his Apgar test (that is, under six), he may require oxygen, or the baby’s airway should be cleared out or require some external stimulation to get the heart rate up. More often, a low score can be a result of a difficult birth, aftereffect of a C-section, or fluid in the baby’s airway.
The 1- Minute Apgar Test Score
If the first score is between four and six, the baby needs help with breathing, which includes massaging and suctioning fluid from the nostrils. If the first score is less than three, the baby requires immediate life-saving measures
The 5- Minute Apgar Test Score
The Apgar score is repeated after 5 minutes to help the doctor to ascertain the baby’s response to the initial medical procedure. A score between seven and ten is considered normal. Even if during the second test the reading remains low say below six, the doctor may decide health saving measures depending on the issue
The Apgar score does not indicate the future health of the baby. It merely indicates the health condition of the baby immediately after birth. Therefore, a low Apgar score does not necessarily indicate any long-term health issues.
Limitations Of The Apgar Score
Apgar score may differ from doctor to doctor. One doctor may not give the same Apgar score to a newborn as another doctor. This score is a mere indicator, your newborn baby may need other tests to determine his current health and his health in the future.
The chances of Apgar’s score being low can be due to the following reasons:
- If your baby is born prematurely
- Problems during pregnancy like any infection or injury due to a fall can cause the low Apgar score
- If you take certain medications, your newborn’s Apgar score can be low
- If you have been dehydrated during labor and delivery, your newborn’s Apgar score will be low
- When your newborn had trouble breathing right after his birth, he would have a low score
- If your newborn had a medical problem during pregnancy, he would have a low score
