The Apgar Score and What it Means

QUESTION: My wife recently gave birth to an adorable baby girl, our first.
During one of my visits to the hospital, our physician and all the hospital
doctors came to visit my wife, and I was asked to wait in the corridor. When
they came out they started to talk about my baby's score, something to do
about breathing. I couldn't understand what they were saying, but it seemed
important, and I have continued to wonder what they were talking about. Can
you help me?
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ANSWER: It is amazing what you can hear in a hospital corridor, particularly
when residents (physicians in training) get excited about a case and fail to
withdraw to a more private area before discussing their findings. It is
evident that all went well with your child, and that the conversation was more
for teaching purposes than actual care, but they were evaluating the Apgar
Score that is given to each new born at 1 minute and 5 minutes after birth.
It is named after Dr. Virginia Apgar, an American anesthesiologist who
designed it to evaluate a baby's status after birth and determine the need for
resuscitation, and to aid in the prediction of future brain function based
upon its condition at the time of delivery. Five factors are evaluated, and
each is given a score from 0 to 2, making 10 the perfect score. They are the
baby's color (as a sign of good oxygenation to the tissues); the heart rate,
the rate of respiration (or breathing); the presence of a reflex when a tube
is placed in the nostril; and the muscle tone based on how the baby moves its
arms and legs. Babies rarely get a score of 10, but when low scores change
rapidly to higher ones after a few minutes, the outlook is good. Any newborn
with a score of 7 or below continues to be checked every 5 minutes to provide
a basis for determining the actions and care necessary to correct any
problems. Of course, now there are many other tests which can be used by the
physician to help assure that prompt and effective treatment will be used to
carry the infant past the initial difficult moments of life, and permit proud
Moms and Dads to display their personal miracle to all the world.