What is the Apgar score? 

It's a way of quantifying your newborn's initial condition and response to any resuscitative efforts. It's determined by a simple assessment that your practitioner will perform at one and then five minutes after your baby's birth. This scoring system has been widely used since obstetric anesthesiologist Virginia Apgar developed it in 1952.

As your practitioner checks each of the following factors - he/she can usually tell what's going on just by looking at your baby - he/she assigns it a score between zero and two. Afterwards, the scores are totaled. (Note that some of these factors, including your baby's heart rate, breathing and color are first assessed immediately after birth so that resuscitation can begin right away if there is any problem.)
  • Heart rate: 
 0 - No heart rate 1 - Fewer than 100 beats per minute - The baby is not very responsive 2 - More than 100 beats per minute - The baby is obviously vigorous
  • Respiration: 
 0 - Not breathing 1 - Weak cry; may sound like wimpering or grunting 2 - Good, strong cry
  • Muscle tone: 
 0 - Limp 1 - Some flexing (bending) of arms and legs 2 - Active motion
  • Reflex response: 
 0 - No response to airways being suctioned 1 - Grimace during suctioning 2 - Grimace and cough or sneeze during suctioning
  • Color: 
 0 - The baby's whole body is completely blue or pale 1 - Good color in body with blue hands or feet 2 - Completely pink or good color

Apgar 

Apgar Scoring
 

Sign

0 points

1 point

2 points

A

Activity (Muscle tone)

Limp

Limbs flexed

Active movement

P

Pulse (heart rate)

Absent

< 100 /min

> 100 /min

G

Grimace (response to smell

Absent

Grimace

Cough or sneeze
 

or foot slap)

    

(nose) cry and withdra-
       

wal of foot (foot slap)

A

Appearance (color)

Blue

Body pink & Extre-

Pink all over
     

-mities blue

  

R

Respiration (breathing)

Absent

Irregular weak crying

Good strong cry

The total Apgar score is the sum of the scores for the five signs

Interpretation - What do the scores mean?
 

The 1-minute Apgar score

The 1st.-Minute Apgar conveys information about your baby's condition after his/her first minute of life and helps the practitioner determine whether he needs any immediate or further treatment. (In some cases, a difficult delivery, premature birth, or medication from the mother may artificially suppress a baby's scores so that the Apgar doesn't depict his true condition.)

Infants who score between: (Don't be disappointed if your baby doesn't get a 10 - a "perfect" score is highly unusual at this point because a baby's extremities are almost never completely pink after only one minute out of the birth canal.):

  • 7 and 10 = good to excellent condition and usually need only routine post-delivery care.

  • 4 and 6 = may require some help breathing, which can be something as simple as vigorously rubbing the baby's skin.

  • < 4 = may be in poor condition and require immediate lifesaving measures.

  • NOTE: AS A GENERAL RULE: Still a low score at this time does not mean that your baby will not eventually be fine.

The 5-minute Apgar score

The 5th.-Minute Apgar helps the doctor determine how your baby has responded to any resuscitative efforts and whether he will continue to need monitoring. A score of:

  • 7 to 10 = is considered normal

  • < 7 = Precaution - aT THIS POINT:

  • Your baby will continue to be observed closely.

  • An Apgar may be done again every five minutes for up to 20 minutes in order to monitor the baby's changing condition.

  • GENERAL RULE: Again, a lower than normal score alone is not an indication of permanent problems and may be explained by prematurity or medication that the mother was given, among other factors.

(BabyCenter.com)