Apgar scale

What is the Apgar score?

is a method for objectively reporting the health of a newborn shortly after it is delivered

graded on a scale from 0-2, 2=normal

What is the five different criteria used for rating?

appearance, pulse rate, grimace, activity, and respiration

Apgar sign score 0

appearance = blue; pale

pulse = absent

Grimace (reflex irritability) = no response to stimulation

activity (muscle tone) = no movement, floppy

respiration = absent

Apgar score 1

appearance = normal body color, except blue hands and feet

pulse = below 100 bpm

grimace = minimal response to stimulation

activity = flexing of arms and legs

respiration = slow; irregular

Apgar score 2

appearance = normal; pink

pulse = above 100 bpm

grimace = pulls away, sneeze or cough

activity = active movement

respiration = vigorous cry

How and when are scores calculated?

one minute and 5 min after birth

7-10 score = good condition

score 3 and below = low; newborn needs immediate medical attention

<5 score = neuromotor dysfunction

scores should not be used alone as a predictor of development

cephalic to caudal

infant develops head and UE control prior to trunk and LE control

Gross to fine

general trend for large muscle movement acquisition w/ progression of small muscle skill acquisition

variable to goal-directed

infant displays a large repertoire of variable movement before they develop goal-directed movement

proximal to distal

midline of the body as reference point

trunk control (midline stability) is acquired first w/ subsequent gain in distal control (extremities)