The Apgar test is a scale whose objective is to obtain an initial assessment of the adaptation to the extrauterine life of the newborn.
Although below we explain what it consists of and how the newborn is assessed with the Apgar Test, you can immediately consult the SalusOne group of experts if you have any questions about its application.
It was first published in 1953 in the journal Current Researchers in Anesthesia and Analgesia under the title “A Proposal for a New Method of Evaluation of the Newborn Infant,” beginning to be used in almost all maternity wards. Apgar is the last name of its creator, Virginia Apgar, an American anesthetist.
It is done by direct observation of the newborn, scoring at three different times:
In the first minute after birth
5 minutes after birth
10 minutes after birth
The final score of the test will be the total sum of the value obtained in 5 parameters, each of them scored from 0 to 2 (0 being the most unfavorable). That is, the higher the score on the Apgar test, the better the newborn’s adaptation to extrauterine life will be. The parameters that are assessed in the Apgar test are:
Heart rate
Respiratory effort
Reflex irritability
Muscular tone
Coloration
The appropriate values in the Apgar test are:
The average heart rate in the newborn is 120-160 bpm, with a regular rhythm.
The average respiratory rate ranges between 40 and 60 bpm. It is more periodic than regular and presents physiological respiratory pauses not exceeding 15 seconds.
Reflex irritability can be assessed according to the newborn’s response to certain stimuli, such as the need for nasogastric aspiration, scoring it according to the reactivity of the NB, being able not to react (0), make a slight grimace, or react with cough or sneeze before introduction (2). The routine in immediate care in the NB of stimulation and aspiration with a nasogastric tube is already banished, so the evaluation of this parameter is not authentic if the passage of the tube is not necessary (we will assume a 2 in the evaluation of the reflex in case of a reactive newborn with good tone and crying at birth).
Muscle tone assesses the posture in which the NB is, being flaccid, presenting slight flexion of the limbs, but somewhat hypotonic (1), or the best score is that they have a good tone with active limb movements.
Coloring is the item that causes most newborns in perfect condition, not to obtain a total of 10, since it is frequent that in the first 24 hours of life, there is acrocyanosis in the hands and feet (bluish coloration skin) due to vasomotor instability.
The Apgar test is the first general evaluation of the baby. It is done at the minute of life and 5 minutes. Many of you will think, “oh well, they did nothing to mine, they put it on me directly,” and that is how it should be, the Apgar test can be performed in skin-to-skin contact, and that is how it should be in any situation that does not require advanced resuscitation of the newborn. It does not require any measuring instrument or move the baby to any specific surface for this purpose.
The usefulness of the Apgar test is that it informs us, through a score, about how well the baby is adapting to the external environment (extrauterine environment) with what vitality she is responding to these changes. It is not only moving from a space where all sensations are silenced, and suddenly they are exposed to light, noise, cold (they are 38 degrees inside the uterus), new tactile sensations … Babies at birth change suddenly your blood circulation and your mode of breathing.
The data that gives us information on whether all this has adequately occurred are five and make up the Apgar test:
- The baby’s heart rate (which is measured by holding the umbilical cord between 2 fingers).
- The skin color (which is appropriate, it suggests that your heart rate is appropriate).
- Your efforts to breathe.
- Your muscle tone (if you are soft or flex your limbs).
- Reflex irritability (how you respond to stimuli).
The person who scores the Apgar test is the same person who attends the delivery.
Each of these five aspects is scored with 0, 1, or 2 points, the highest score being the one that indicates the best adaptation of the baby to the extrauterine environment. As there are five parameters, the lowest score would be 0 and the highest 10 (corresponding to scoring a 2 for each item). The Apgar at minute rarely reaches ten because the extremities at the minute of birth are not usually still as pink as the rest of the body, which subtracts one point.
Some parents worry that their baby is not crying at all being born, but the baby may well have an Apgar of 10. An Apgar above 7 indicates good adaptation. Below 7 requires stimulation. It is usually enough to rub it gently with a towel as if we were drying it.
The Apgar score usually appears in the reports as number/number, which corresponds to the Apgar at minute / Apgar at 5 minutes, so that an 8/10 indicates that the score at one minute of life is an eight and at 5 minutes a 10. The usual thing is that the Apgar at 5 minutes reaches the highest possible score
The Apgar test is the first of the assessments that are made to a baby at birth. This and other tests establish if she is well or has a problem that needs to be addressed.
The Apgar test was created by Virginia Apgar, an American anesthesiologist, in 1953. It soon became an indispensable tool, helping to reduce neonatal mortality. She also laid the foundation for modern neonatology.
Currently, all newborns must undergo the Apgar test. This takes place one minute after birth and is repeated five minutes later. From there, a score is obtained that allows to know if the baby is well or not.
What is the Apgar test?
Baby being listened to
After delivery, the Apgar test is performed to determine the health status of the newborn.
The Apgar test is an assessment that is made on newborns. The goal is to detect possible problems quickly and without discomfort for the baby. What is sought with this exam is to attend to the newborn instantly, if required.