The Apgar test of the newborn baby
The transition of the newborn from intrauterine to extrauterine life involves many changes and it is important to assess whether this transit occurs normally. This assessment is done with the Apgar test, a practical method to assess newborn babies immediately after delivery and to identify those who need resuscitation.
The Apgar test of the newborn baby has five parameters whose result indicates the state of health and well-being of the newborn. Each parameter is scored from 0 to 2, so the maximum score is 10 and the minimum is 0.
What does the Apgar test of the newborn baby value?
In the Apgar test, we value:
1. The heart rate in beats per minute (ppm) It is measured by counting the number of beats per minute of the baby's heart. If it lacks pulsations, the score is zero. If the count is higher than 100 ppm, it is valued with a point and if it is lower with 2 points.
2. The respiratory effort. If you are absent, you receive 0 points; if it is poor and irregular, 1 point and if it is good and accompanied by crying, 2 points.
3. Muscle tone. It measures the degree of flexion that the arms and legs of the newborn baby have. If the tone is loose it is valued with 0 points, if it presents certain flexion in the extremities with 1 point and presents an active movement, with 2 points.
4. The color of the baby's skin. It does not receive a score when it is bluish or pale. It is valued with 1 point when the body is pink and the extremities blue and with two points when the body, in its entirety, is pink.
5. The response to a probe (long, thin and hollow tube) inserted through the nose receives a point when the baby gesticulates and two points when coughing or sneezing.
When is the Apgar test calculated?
The Apgar test is measured at minute and 5 minutes. A score of 7 to 10 is considered normal. In most cases the Apgar test It is 9 at minute and 10 at 5 minutes, which indicates that it is a healthy neonate. A score of less than 7 may indicate that the child needs some resuscitation maneuver.
What has changed in the current assessment of the newborn?
Although the Apgar test is still in force, the systematic nasopharyngeal aspiration of the newborn is not currently recommended, thus avoiding the use of the nasal tube to avoid interfering with the first mother-child contact. In practice, the need to perform resuscitation maneuvers in a neonate can be taken by assessing only breathing and muscle tone.
Why is it called Apgar test?
The test is named after the person who described it: the doctor. Apgar. Virginia Apgar (1909-1974) was the first woman professor of Anesthesiology at Columbia University. The idea that inspired his test was the response to the criticism of a medical student who reproached him in the hospital cafeteria for the lack of a reliable method to assess the newborn. Dr. Apgar took it seriously and, on the back of a note for clients of the bar where they indicated what to do with the trays, wrote the postnatal assessment test that has immortalized her name.
Isidro Vitoria Miñana. Pediatrician of the Nutrition and Metabolopathies Unit of the La Fe Hospital in Valencia. Author of the bookBaby care. Truths, myths and mistakes, by Ed. Medici 2014.
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Recommended by:
- AEPAP Spanish Association of Primary Care Pediatrics
- SEDCA Spanish Society of Dietetics and Food Sciences
- Family Lighthouses. Page for parents of the San Joan de Deu Hospital. Barcelona.
