If the baby is in good condition, she will get a score of 8 to 10 points. If he scores 4 to 6 points, his physiological condition is not responding adequately, and the newborn requires a clinical evaluation and immediate recovery.
If it is less than 4, you need emergency care such as IV medications and assisted breathing. Each of these categories is given a 0, 1, or 2, depending on the state observed in the newborn.
1. Heart rate
Heart rate is assessed with the stethoscope and is the most critical assessment.
If there is no heartbeat, the baby’s score is 0 for heart rate.
If the heart rate is less than 100 beats per minute, the baby’s heart rate score is 1.
If the heart rate is above 100 beats per minute, the baby’s heart rate score is 2.
2. Respiratory effort
If there are no breaths, the baby scores 0 for respiratory effort.
If the breaths are slow or irregular, the baby scores 1 for respiratory effort.
If the cry is good, the baby’s score is 2 for respiratory effort.
3. Baby’s muscle tone
If the muscle tone is flabby, the baby’s score is 0 for muscle tone.
If there is some flexion of the limbs, the baby scores 1 for muscle tone.
If there is active movement, the baby’s score is 2 for muscle tone.
4. Reflex of irritability
Irritability reflex is a term that describes the newborn’s level of irritation in response to stimuli (such as a mild pinprick).
If there is no fussy reflex, the baby’s score is 0 for fussy reflex.
If there are gestures, the baby’s score is 1 reflecting irritability.
If there are gestures or vigorous coughing, sneezing, or crying, the baby’s score is 2 reflecting irritability.
5. Baby’s skin coloring
If the coloration is pale blue, the baby’s score is 0 coloration.
If the baby’s body is pink and the limbs are blue, the score is 1 for coloration.
If the entire body of the baby is pink, the score is 2 for coloration.
The 1-minute APGAR score assesses the newborn’s tolerance level to the birthing process, while the 5-minute APGAR score assesses the newborn’s level of adaptability to the environment.
Apgar test achievements
This exam is an evaluation tool for doctors, helping them determine what kind of immediate help the newborn needs to stabilize. A score of 8 to 10 is average and indicates that the newborn is in good condition. A score of 10 is very unusual, and almost all newborns lose a point for bluish hands and feet.
Any score less than 8 indicates that the child needs help stabilizing. A lower score in the first minute, which normalizes at five minutes, has not been associated with possible long-term adverse effects.
Thanks to this method, and during the more than 50 years that it has been carried out, it has been possible to reduce the mortality rate and the morbidity rate by evaluating the baby’s condition immediately after birth. The APGAR test is lifetime data for Children’s Public Health.
Ultrasounds, blood and urine tests, blood pressure measurements, glucose control, amniotic fluid test (amnioscopy), and other types of tests such as control of uterine contractions (topography) are part of the list of tests that can be performed during pregnancy to check that everything is going well and that the baby is growing normally.
Once the birth has arrived, it is necessary to determine that the baby is in perfect condition by performing the tests directly on him. The first analysis of his life is called the Apgar test, a test developed by the anesthetist Virginia Apgar, from the Children’s Hospital of Columbia University, in the United States, more than 60 years ago, with which we measure five parameters: Appearance, Pulse, Gesticulation, Activity, and Breathing.
What is it for?
This test is performed by the specialist in Neonatology present at the birth and is carried out to know the physical state of the newborn and rule out the need for medical care or emergency treatments. It is done in two phases. At minute 1, just after birth, to find out how the baby has endured the birth process and, later, at minute 5 after delivery, to check her adaptation to extrauterine life.
Sometimes, when the baby’s physical condition is problematic or if the second test results have a low score, it is necessary to repeat it ten minutes after birth. In this case, the results of this new test indicate if the baby needs help with breathing or suffers e cardiovascular problems, for example.
How is it performed?
The neonatologist present at the delivery analyzes five aspects of the baby:
– Appearance: Skin color or appearance
– Pulse: Heart rate
– Gesticulation: Reflexes or irritability
– Activity: Muscle tone
– Breathing: Respiratory effort and rhythm
What are the test scoring criteria?
Respiratory effort gets a 0 when the baby is not breathing; a score of 1 if the newborn presents irregular, slow breaths or weak cries, and two points are given to the child when his rhythm and effort are normal and crying is adequate.
The heart rate rating, which is examined with the stethoscope, is 0 points if the newborn does not have a pulse, 1 point if it is less than 100 beats per minute, and 2 points when the baby’s heart usually beats more than 100 beats per minute.
Muscle tone is of concern when there is no movement and the muscles are loose and floppy, a situation in which the child will be given a score of 0 points. If the arms and legs are flexed and have little movement, muscle tone will be scored 1 point, and if there is an active and spontaneous movement, the score will be 2.
The reflex response to stimulation, such as with a tiny pinprick or placing a small catheter in the nose, is scored with 0 points if the newborn does not react; with 1 point when there is a slight facial gesture or discreet grimaces, and with a 2 in cases in which the baby gestures, coughs, sneezes or cries when stimulated.
The skin color will receive 0 points if it is bluish, grayish, or pale all over the body; 1 point when the baby has a pink tone, but the hands and feet are blue, and 2 points when it has a standard, pink tone, all over the body.
How do I interpret the test results?
Expected values, seven and up. The higher the scores are given in these five aspects, the better the newborn will do after birth. Scores of 7, 8, and 9 are considered average results, meaning the child is in good health. Few babies get a 10, as most are born with bluish limbs.
Scores below 7. Scores below 7 mean the baby needs some medical intervention. Help will become more urgent for the baby to adapt to the new environment the lower the final score. This is usually low after a cesarean section or a complicated delivery when fluid is in the airways or premature babies. In these cases, your baby may need to enter the Neonatology Unit of the Hospital. The neonatologist will explain to you at all times what steps are going to be followed for the best care of the baby and that you can spend as much time as possible with him.