- Apgar score was invented in 1952
- Apgar score assesses newborns during the first moments of their life.
- The Apgar score is recorded at 1 and 5 minutes of birth
June 7 marks the 109th birth anniversary of American anaesthesiologist Dr Virginia Apgar, who is credited for creating the 'Apgar Score' that determines the health of a newborn baby. To honour her commendable invention, Google created a special Google Doodle on her birthday. The Apgar Score is the measure of physical condition of newborn infant. It is obtained by adding by points 0, 1 or 2 for response to stimulation, heart rate, respiratory effort, muscle tone and skin colouration. A score of 10 is representative of the best condition, a healthy baby. It was because of several medical conditions in her family which compelled her to develop an interest in medicine and science. She completed a residency in surgery in 1949. Some of her commendable accolades include her becoming the first female professor at Columbia University College of Physicians and Surgeons (P&S) in 1949. In the 1950s, Dr Apgar along with her colleagues gave Apgar Score for thousands of babies. It was the time when infant mortality in the US was on the rise. Until the 1960s, the Apgar Score become an important shorthand form of recording child's health - especially during the first 24 hours of life. She co-wrote the book "Is my baby all right?" in 1972. The book explained causes and treatment of various birth defects. She passed away in 1974.
Ever since its invention in 1952, the Apgar score has been used by medical professors all across the world for assessing newborns during the first moments of their life. The score helps in assessing the overall condition of the baby. A baby with low Apgar score may need special care and attention.
After birth, the nurse or the doctor may announce Apgar score in the labour room itself. This lets the doctors know how the baby is doing, even if some of them are attending the mother at that time.
The parents should be aware of the fact that the Apgar score is one of the many assessments which doctors can use.
How the Apgar score works?
The Apgar score is divided into 5 categories, where each category gets 0 to 2 to points depending on the child's health. A child should ideally receive a score of 10, but this score is quite rare in the first few moments of life. A score of 10 is rare because most babies have blue hands or feet immediately after birth.
The 5 categories of Apgar score include activity or muscle tone (A); heart rate or pulse (P); grimace or response to stimulation (G); appearance (A) and respiration or breathing (R).
For category A, 0 points are given if muscle tone is limp of floppy, 1 point if the limbs are flexed and 2 points if there is active movement.
For category P, 0 points for absent pulse, 1 point if there are less than 100 beats per minute and 2 points if there are more than 100 beats per minute.
For category G, 0 points are given if the response - to stimulation such as suctioning the baby's nose is - is absent. 1 point is given if there is facial movement, and 2 points are given if there is coughing, sneezing, crying or withdrawal of foot with stimulation.
For category A, 0 points are given if the baby is blue, bluish-grey or pale all over. 1 point is given if the baby has pink body but in extremities of blue. 2 points are given to an all over pink baby.
For category R, 0 points are given if respiration or breathing is absent. 1 point is given if it is irregular and is coupled with weak crying and 2 points are given if the breathing is good along with strong crying.
The Apgar score is recorded at 1 and 5 minutes. In case the baby's score are low in 1 minute, more doctors are called to intervene and begin with necessary action. The condition should ideally improve at 5 minutes. If the score continues to be low after 5 minutes, the score is reassessed after 10 minutes. Babies with complicated deliveries, preterm babies and babies born through caesarean delivery are likely to have low Apgar scores.
What is normal Apgar score?
A score between 7 to 10 after 5 minutes of birth is considered to be reassuring. A score of 4 to 6 is considered to be moderately abnormal. 0 to 3 Apgar score is a matter of concern. This score needs intervention like added assistance for breathing. Parents may see nurses drying the child off vigorously or delivering oxygen through a mask. The midwife or nurse is asked by the doctor to transfer the patient to neonatal intensive care nursery for further assistance.
The Apgar score is usually not considered perfect by many doctors. With time, there have been modifications to the Apgar score like Combined-Apgar score - which takes into consideration the interventions which the baby has received along with the baby's Apgar score. The Combined-Apgar score is 17 at the max. A score of 17 is indicative of a bay who hasn't received any interventions and receives all points. A score of 0 is for the baby who didn't respond to interventions.
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