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Alison Ross, Midwife
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Registered Midwife, DipHe, BSc (Hons) Was a midwife at Kingston Hospital and Specialist Midwife in Perinatal Mental Health.
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Birth and labour

The Apgar test

The Apgar scale was developed by Dr. Virginia Apgar in the 1950s. Since that time it has been used internationally to quickly assess babies straight after they are born. It helps your obstetrician, paediatrician, midwife or medical team decide if your baby needs any special care after birth.
In Short

The test has been criticised for being too simple but remains one of the first assessments your baby will have.

The first assessment is given at 1 minutes after birth, the second after 5 minutes.

A score of 0, 1 or 2 is given for each of the following characteristics:

Appearance

Pulse

Grimace

Activity

Respiration

The APGAR test checks the following signs in a newborn baby:

Appearance

0 = blue/pale all over

1 = blue at extremities

2 = pink

Pulse

0 = no pulse

1 = less than 100 beats per minute

2 = more than 100 beats per minute

Grimace (Irritability to response)

0 = no response

1 = grimace or feeble cry to pain stimulus

2 = cry or pull away from pain stimulus

Activity

0 = none, floppy

1 = some flexing of limbs

Respiration

0 = no breathing

1 = weak, gasping or irregular breathing

2 = strong loud cry

What does the score show?

Most newborn babies are given a score above 7 and need no further help. An Apgar Score of 5-7 may indicate help is needed with breathing – probably nothing more than vigorously rubbing the baby’s body. If a baby had a score below 5 after five minutes, a paediatrician would be called. The baby would be placed into a hot cot or resuscitation trolley that is in every delivery room and be given oxygen, or in extreme cases, emergency first aid to attempt to encourage him to breathe.

A low score does not necessarily mean that your baby has a long-term problem. It is likely to be lower if you have had a complicated birth, have given birth prematurely, or even had pethidine during labour.

DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.