Apgar score

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Apgar score is a method to quickly summarize the health of newborn children against infant mortality. Dr. Virginia Apgar, an anesthesiologist at NewYork-Presbyterian Hospital, developed the score in 1952 to quantify the effects of obstetric anesthesia on babies.

The Apgar scale is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria are summarized using words chosen to form a backronym (Appearance, Pulse, Grimace, Activity, Respiration).

Video Apgar score

Criteria

The five criteria of the Apgar score:

Maps Apgar score

Interpretation of scores

The test is generally done at 1 and 5 minutes after birth, and may be repeated later if the score is and remains low. Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low and cause for immediate resuscitation efforts.

A low score on the one-minute test may show that the neonate requires medical attention but does not necessarily indicate a long-term problem, particularly if the score improves at the five-minute test. An Apgar score that remains below 3 at later times--such as 10, 15, or 30 minutes--may indicate longer-term neurological damage, including a small but significant increase in the risk of cerebral palsy. However, the Apgar test's purpose is to determine quickly whether a newborn needs immediate medical care. It is not designed to predict long term health issues.

A score of 10 is uncommon, due to the prevalence of transient cyanosis, and does not substantially differ from a score of 9. Transient cyanosis is common, particularly in babies born at high altitude. A study that compared babies born in Peru near sea level with babies born at very high altitude (4340 m or 14,138 ft) found a significant average difference in first Apgar score, but not the second. Oxygen saturation (see Pulse oximetry) also was lower at high altitude.

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Backronym

Some ten years after initial publication, a backronym for APGAR was coined in the United States as a mnemonic learning aid: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.

Spanish: Apariencia, Pulso, Gesticulación, Actividad, Respiración;

Portuguese: Aparência, Pulso, Gesticulação, Atividade, Respiração;

French: Apparence, Pouls, Grimace, Activité, Respiration;

German: Atmung, Puls, Grundtonus, Aussehen, Reflexe, representing the same tests but in a different order (respiration, pulse, muscle tone, appearance, reflex).

Another eponymous backronym from Virginia Apgar's name is American Pediatric Gross Assessment Record.

Another mnemonic for the test is "How Ready Is This Child?" - which summarizes the test criteria as Heart rate, Respiratory effort, Irritability, Tone, and Color.

src: pediatrics.aappublications.org

See also

• Ballard Maturational Assessment
• Bishop score
• Glasgow Coma Scale
• Paediatric Glasgow Coma Scale

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References

src: www.bmj.com

Further reading

• Apgar, Virginia (1966). "The Newborn (Apgar) Scoring System: Reflections and Advice" (PDF). Pediatric clinics of North America. 13: 645-650.  (Retrieved from Profiles in Medicine-The Virginia Apgar Papers)

Source of article : Wikipedia