Our easy-to-use and easy-to-understand APGAR Score Chart helps you to understand how APGAR score is calculated.
APGAR Score Chart
| APGAR Sign | 2 | 1 | 0 |
|---|---|---|---|
| Appearance (skin color) | Normal color all over (hands and feet are pink) | Blue at extremities, body pink (acrocyanosis) | Blue or pale all over |
| Pulse (heart rate) | Normal (above 100 beats per minute) | Below 100 beats per minute | Absent (no pulse) |
| Grimace (“reflex irritability”) | Pulls away, sneezes, coughs, or cries with stimulation | Facial movement only (grimace) with stimulation | Absent (no response to stimulation) |
| Activity (muscle tone) | Active, spontaneous movement | Arms and legs flexed with little movement | No movement, “floppy” tone |
| Respiration (breathing rate and effort) | Normal rate and effort, good cry | Slow or irregular breathing, weak cry | Absent (no breathing) |
What is the APGAR Score?
The Apgar score is a method to quickly summarize the health of newborn children against infant mortality. Virginia Apgar, an anesthesiologist at New York–Presbyterian Hospital, developed the score in 1952 to quantify the effects of obstetric anesthesia on babies. In 1953, Apgar published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief, and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Apgar stands for “Appearance, Pulse, Grimace, Activity, and Respiration.”
Interpretation of APGAR score
APGER test is generally done at one and five minutes after birth (may be repeated later if the score remains low).
| APGAR SCORE | INTERPRETATION |
|---|---|
| 7 or above | generally normal |
| 4 to 6 | fairly low |
| 3 and below | are generally regarded as critically low and cause for immediate resuscitative efforts |
A low score on the one-minute mark may show that the neonate requires medical attention, but does not necessarily indicate a long-term problem, particularly if the score improves at the five-minute mark.