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 Release 22.0, Sept. 2008
 
Chapter : ch44. Pediatrics Section : Assessment of Neonatal Well-Being and Development
  Apgar Score

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Overview :

The Apgar scoring system is used to assess newborn infants for depression of cardiopulmonary and neurological function. Scoring is done at 1 and 5 minutes after birth.

 

Parameter

Finding

Points

color

blue, pale

0

 

body pink, extremities blue

1

 

all pink

2

heart rate

absent

0

 

< 100

1

 

> 100 (will use >= 100)

2

respiration

absent

0

 

irregular, slow

1

 

good, crying

2

reflex response to nose catheter

none

0

 

grimace

1

 

sneeze, cough

2

muslce tone

limp

0

 

some flexion of extremities

1

 

active

2

 

Apgar score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

• The lower the score the more profoundly affected the infant is, with scores under 5 considered serious.

• A low initial scores with no improvement in the 5 minute score is associated with neonatal problems including death.

 

  References:

Apgar V. A proposal for a new method of evaluation of the newborn infant. Anesth Analg. 1953; 32: 260.

Berkow R, Fletcher AJ, et al. The Merck Manual of Diagnosis and Therapy, 16th edition. 1992. pages 1978-1979.

Graef JW. Manual of Pediatric Therapeutics, 5th edition. Little, Brown and Co. 1994.

Nelson WE, Behrman RE, et al (editors). Nelson Textbook of Pediatrics, 15th Edition. WB Saunders Company. 1996. Chapter 79: The newborn infant, pages 433-440. Table 79-2, page 438

 

 

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