The Apgar test, how to interpret the results
Once the time of birth has arrived, it must be determined that the newborn baby is in perfect condition by directly testing him. The first analysis of his life is named after Apgar test and their results are set at a score of 0 to 10. We tell you how to interpret them.
The Apgar test is a test developed by the anesthesiologist Virginia Apgar, from Children's Hospital of the University of Columbia, in the United States, more than 60 years ago, with which we measured 5 parameters: Appearance, Pulse, Gesture, Activity and Breathing.
How is the Apgar test performed on the newborn baby?
The neonatologist present at birth analyzes with the Apgar test five aspects of the baby:
- Appearance: Skin color or appearance
- Pulse: Heart rate
- Gesturing: Reflexes or irritability
- Activity: Muscle tone
- Breathing: Respiratory effort and rhythm
What are the criteria for scoring the test?
The respiratory effort gets 0 when the baby does not breathe; a score of 1 in the event that the newborn presents irregular, slow respirations or weak crying, and the child is given two points when his rhythm and effort are normal and the crying is adequate.
The heart rate rating, which is examined with the stethoscope, is 0 points if the newborn has no pulse; 1 point if it has less than a hundred beats per minute, and 2 points when the baby's heart beats normally, at more than a hundred beats per minute.
Muscle tone It is worrying when there is no movement and the muscles are limp and flaccid, situation in which the child will be given a score of 0 points. If the arms and legs are flexed and have little movement, the muscle tone will be scored with 1 point and if there is active and spontaneous movement, the score will be 2.
The response reflects the stimulation, as for example, with a small puncture or placing a small catheter in the nose, it is valued with 0 points if the newborn does not react; with 1 point when there is a slight facial gesture or discreet grimaces, and with a 2 in the cases in which the baby gesticulates, coughs, sneezes or cries before the stimulation.
The color of the skin will receive 0 points if it is bluish, grayish or pale throughout the body; 1 point when the baby has a pink tone but the hands and feet are blue, and 2 points when it has a normal tone, pink, throughout the body.
How are the results of the Apgar test interpreted?
- Normal values, from 7 up. The higher the total sum of the scores awarded in these five aspects of the Apgar test, the newborn will evolve better after birth. The scores of 7, 8 and 9 are considered a normal result, which means that the child is in good health. Few babies get a 10, since most are born with bluish limbs.
- Scores below 7. Grades below 7 assume that the baby needs some type of medical intervention. The help will become more urgent so that the baby adapts to the new surroundings according to the final score. This is usually low after a cesarean section or a complicated delivery, when there is fluid in the respiratory tract or in premature babies. In these cases, your baby may need to enter the Hospital Neonatology Unit. The Neonatologist will explain at every moment what steps will be taken for the best care for the baby and that you can spend with him as long as possible.
What is the purpose of the Apgar test?
This Apgar test is performed by the specialist in Neonatology present at delivery and is carried out to know the physical state of the newborn and rule out the need for medical care or emergency treatment. It is carried out in two phases:
- At minute 1, just after birth, to know how the baby has endured the birth process.
- Subsequently, at minute 5 after delivery, in order to check their adaptation to extrauterine life.
Sometimes, when the physical state of the baby is worrisome or if the results of the second analysis have a low score, it is necessary to repeat it ten minutes after birth. In this case, the results of this new test indicate whether the baby needs help with breathing or suffers from cardiovascular problems, for example.
Dr. Paloma Nacher. Neonatologist at the Hospital La Milagrosa in Madrid.