Apgar score

Sums the numerical value of 5 clinical variables obtained 60 seconds after birth: heart rate, respiratory effort, reflex irritability, muscle tone and color.

Method to evaluate the physiologic condition and responsiveness of newborn infants and their chances for survival.

Normal 7-10 at one minute.

A score is assigned to virtually every newborn in a hospital.

A score at 5 minutes shows a stronger correlation than the one-minute score for neonatal mortality.

Using such scores alone is unsatisfactory for defining birth asphyxia or predicting neurologic outcome.

The Apgar score is determined by evaluating the newborn baby on five criteria: Appearance, Pulse, Grimace, Activity, Respiration (APGAR).

Apgar score-evaluation:

Heart rate: Absent (O), Below 100 (1),Over 100 (2).

Respiratory effort: Absent(0),Slow, irregular (1), Good, crying (2).

Muscle tone: Limp (0), Some flexion of extremities (1), Active motion (2).

Response to catheter in nostril:None (0), grimace (1), Sneeze/cough (2).

Color: Blue, pale (0), Pink body blue extremities (1), Pink all over.

Total score of 10 means the best possible condition of the infant.

Score at 5 minutes of 0-1 associated with a one month mortality of 50%.

A low Apgar score, commonly defined as less than four or less than seven, is associated with an increased risk of neonatal death among term infants.
Apgar score is at five and 10 minutes provide prognostic information about neonatal survival among preterm infants across gestational age strata.

One month mortality 20% with a score of 4 and almost 0% when the score is 7 or greater.

Among term infants with five-minute Apgar scores in the normal range 7-10, the risk of neonatal death was higher among those with a score of seven or eight then among those with the score of nine or 10.

Not a reliable indicator of long-term neurologic morbidity.

The Apgar score was developed to assess term infants during a time when neonatal mortality was very high among preterm infants.
The frequency of low Apgar scores increases with decreasing gestational age and may reflect biologic immaturity in preterm infants.
In the study of preterm infants the five and 10 minute Apgar score provided prognostic information about neonatal survival.

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