APGAR

Alternative names:

newborn scoring

How the test is performed:

Five categories are assessed:

• heart rate
• respiratory effort
• muscle tone
• reflex irritability
• color

Each of these categories is scored with 0, 1, or 2, depending on the observed condition of the newborn.

• Heart Rate: Heart rate is evaluated by stethoscope. This is the most important assessment.
  • If there is no heart beat, the infant scores 0 for heart rate.
  • If there is a heart beat less than 100 beats per minute, the infant scores 1 for heart rate.
  • If there is a heart beat greater than 100 beats per minute, the infant scores 2 for heart rate.

• Respiratory Effort:
  • If there are no respirations, the infant scores 0 for respiratory effort.
  • If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
  • If there is good crying, the infant scores 2 for respiratory effort.

• Muscle Tone:
  • If the muscle tone is flaccid, the infant scores 0 for muscle tone.
  • If there is some flexion of the extremities, the infant scores 1 for muscle tone.
  • If there is active motion, the infant score 2 for muscle tone.

• Reflex Irritability: Reflex irritability is a term describing the level of newborn irritation in response to stimuli (such as a mild pinch).
  • If there is no reflex irritability, the infant scores 0 for reflex irritability.
  • If there is grimacing, the infant scores 1 for reflex irritability.
  • If there is a vigorous cry, the infant scores 2 for reflex irritability.

• Color:
  • If the color is pale blue, the infant scores 0 for color.
  • If the body is pink and the extremities are blue, the infant scores 1 for color.
  • If the entire body is pink, the infant scores 2 for color.

The 1-minute APGAR score assesses how well the newborn tolerated the birthing process. The 5-minute APGAR score assesses how well the newborn is adapting to the environment.

Why the test is performed:

This test is a screening tool for health care providers to determine what assistance is immediately necessary to help your newborn stabilize.