APGAR

• 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.

Risks:
No risks are associated with the APGAR test.

Why this 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.

Normal Values:
A score of 8 to 10 is normal and indicates your newborn is in good condition. A score of 10 is very unusual. Almost all newborns lose 1 point for blue hands and feet.

Abnormal Results:
Any score less than 8 indicates your child needs assistance stabilizing.

Cost:
There is no specific charge for this test. It is part of the delivery service.


An evaluation of the newborn's condition is done immediately after delivery and again at five minutes, to determine the APGAR scores. If some cyanosis (bluish skin) is present, the APGAR scores are lower and oxygen may be administered. The oxygen can often be merely blown by the newborn's face, through the mask in front of the infant.