What is the APGAR Test?

APGAR Score Calculator

APGAR Score Calculator

The APGAR test for newborn responsiveness was developed by the anesthesiologist Virginia Apgar in 1952. She devised the checklist to judge the effects of obstetric anesthesia on newborns. The word "APGAR" became a backronym to help medical professionals remember the five checkpoints in computing the APGAR score.

The five components of the test are Appearance, Pulse, Grimace, Activity, and Respiration. Each criterion is scored from 0 to 2, with 2 being the healthiest and 0 being critical. When all of the five component scores are added, you obtain a number that ranges from 0 to 10. This is the APGAR Score. An APGAR score between 0 and 3 is considered critical and requires immediate attention. Scores ranging from 4 to 6 are low and newborns should be monitored closely. Scores between 7 and 10 are normal for newborns.

The APGAR score is a diagnostic tool used immediately following birth; it does not provide any useful information about health beyond the first few minutes of life, and does not predict long-term health.

APGAR Score Components

Appearance: If the baby's body, arms, legs, fingers, and toes are pink, the appearance score is 2. If the baby's body is pink and gradually fades to blue at the extremities, the appearance score is 1. For newborns whose body is very pale or blue, the appearance score is 0.

Pulse: A pulse of at least 100 beats per minute earns a score of 2. If the pulse is present but less than 100 bpm, the score is 1. In the absence of any heartbeat, the pulse score is 0.

Grimace: If the newborn shows a strong negative reaction to being stimulated--cries and grimaces--the score is 2. If the baby makes a weaker display of agitation, the score is 1. For no response, the grimace score is 0.

Activity: If the baby is moving his arms and legs, flexing them and resisting when one tries to extend them, then the activity score is 2. If the baby shows some flexing but an overall weaker response, the score is 1. For no activity or flexing, the score is 0.

Respiration: For newborns who exhibit strong lungs with a loud cry, the respiration score is 2. If the baby is breathing, but the breaths are more irregular and the cry is weaker, the score is 1. If the baby is not respirating, the score is 0.

Keep in mind that the APGAR score is only assessed just after birth. It is not meant to predict long-term health, but only to assess if baby needs medical attention due to effects of anesthesia.

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