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APGAR

Definition

APGAR is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the doctor how well the baby is doing outside the mother's womb.

The test may rarely be done 10 minutes after birth.

Alternative Names

Newborn scoring

How the test is performed

The APGAR test is done by a doctor, midwife, or nurse. The health care provider will examine the baby's:

  • Breathing effort
  • Heart rate
  • Muscle tone
  • Reflexes
  • Skin color

Each category is scored with 0, 1, or 2, depending on the observed condition.

  • Breathing effort:
  • Heart rate is evaluated by stethoscope. This is the most important assessment:
  • Muscle tone:
  • Grimace response or reflex irritability is a term describing response to stimulation such as a mild pinch:
  • Skin color:

How to prepare for the test

How the test will feel

Why the test is performed

This test is done to determine whether a newborn needs help breathing or is having heart trouble.

Normal Values

The APGAR rating is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.

A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.

What abnormal results mean

Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjusting outside the mother's womb.

Most of the time a low Apgar score is caused by:

  • Difficult birth
  • C-section
  • Fluid in the baby's airway

If your child has a low Apgar score, he or she may receive:

  • Oxygen and clearing out the airway to help the baby breathe
  • Physical stimulation to get the heart beating at a healthy rate

Most of the time, a low score at 1 minute is near-normal by 5 minutes.

A lower Apgar score does not mean a child will have serious or long-term health problem. The Apgar score is not designed to predict the future health of the child.

Special considerations

References

Haddad GG, Green TP. Diagnostic approach to respiratory disease. In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 366.

Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.