Apgar test

From Embryology

Introduction

Virginia Apgar (1909-1974)

A historic neonatal test designed by Dr Virginia Apgar[1] used in nearly all maternity clinics to assess the newborn infants well being assigned scores for each of 5 indicators: Heart Rate, Respiratory Effort, Reflex Irritability, Muscle Tone, Colour

Measured at one and five minutes after birth the Score values are totalled for all indicators: 7-10 is considered normal, 4-7 may require resuscitative measures, 3 and below require immediate resuscitation.

In recent years there has been some controversy of the relevance and accuracy of some of the criteria used in this test, though many feel it is still an invaluable initial assessment tool particularly where medical services are limited.

Apgar Test Scores

Apgar.jpg
  • Measured at one and five minutes after birth.
  • The Score values are totalled for all indicators
    • 7 to 10 is considered normal
    • 4 to 7 may require resuscitative measures
    • 3 and below require immediate resuscitation


Indicator Score 0 Score 1 Score 2
Activity
(muscle tone)
Limp; no movement Some flexion of arms and legs Active motion
Pulse
(heart rate)
No heart rate Fewer than 100 beats per minute At least 100 beats per minute
Grimace
(reflex response)
No response to airways being suctioned Grimace during suctioning Grimace and pull away, cough, or sneeze during suctioning
Appearance
(color)
The baby's whole body is completely bluish-gray or pale Good color in body with bluish hands or feet Good color all over
Respiration
(breathing)
Not breathing Weak cry; may sound like whimpering, slow or irregular breathing Good, strong cry; normal rate and effort of breathing

Recent Apgar Studies

  • management of eclampsia patients [2] "A five-minute Apgar score <7 has a consistent association with prevalence of neurologic disability and with low cognitive function in early adulthood."

Reassessment of Apgar Score

Two large 2001 neonatal studies have examined whether the Apgar score is still a relevant neonatal assessment tool.

  1. Low 5-minute Apgar score: a population-based register study of 1 million term births.[3] "Several obstetric risk factors are associated with low 5-minute Apgar score in term infants. Mortality and the risk of severe neurologic morbidity are increased in these infants."
  2. The continuing value of the Apgar score for the assessment of newborn infants.[4]"The Apgar scoring system remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago."

References

  1. <pubmed>13083014</pubmed>
  2. <pubmed>19323846</pubmed>
  3. <pubmed>11430958</pubmed>
  4. <pubmed>11172187</pubmed>

Search Pubmed

Search PubMed May 2010 "Apgar test" All (2327) Review (70) Free Full Text (294)

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Cite this page: Hill, M.A. (2024, March 29) Embryology Apgar test. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Apgar_test

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© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G