Apgar test for babies: method of administration and criteria

The Apgar test is a test applied to newborns. It involves assessing their aptitude in five main areas to determine whether they need medical attention.

In this article we will describe the five criteria of the Apgar test and its mode of administration. It should be borne in mind that although this is a useful test, its results are superficial and it is important to supplement them with other in-depth examinations.

    What is the Apgar test?

    It is very common for evaluation tests to be done soon after giving birth to see if the baby is responding normally to different types of stimulation and if their nervous system is functioning properly.

    The Apgar exam is one of the most popular neonatal assessment methods. It involves observing five functions or characteristics of the baby that are relevant at an informative level: skin color, heart rate, reflective irritability, muscle tone, and breathing. The name comes from its creator, obstetric anesthesiologist Virginia Apgar.

    The objective of this test is to determine the degree of perinatal stress that the baby is undergoing in order to assess whether he needs medical attention or if he can survive without outside help, taking these five criteria as a baseline.

    Other tests used to assess the condition of newborns are the Prechtl test, which also assesses posture, spontaneous movements or facial expressions, and the Brazelton Neonatal Behavior Rating ScaleCriteria include social interaction, muscle capacity, alert control, and physiological stress response.

      Administration mode

      The Apgar test is applied by medical or nursing staff one minute after birth, and it happens again five minutes after childbirth. In this way, a general and quick idea of ​​the baby’s condition can be obtained, although the information provided by this examination is limited because it only detects obvious complications.

      The five variables we have mentioned (and which we will describe in detail in the next section) are noted from 0 to 2; while the minimum rating is an indication that there are very serious problems in this area, the 2 indicates normal and healthy functioning.

      Since there are five criteria that can be scored with a maximum of 2, the final result will always be between 0 and 10. The higher the overall score, the better the physical condition of the child; if it is less than 4, the little one will need urgent medical attention, while if it is between 4 and 7, a more detailed assessment will need to be done.

      Apgar review criteria

      The areas analyzed by the Apgar test constitute a representative sample of the basic physiological responses of newborns. Although scores are added to each criterion to achieve an overall score, a 0 and even a 1 in any of the variables can be important warning signs that the child is having physical problems.

      The term “Apgar” is an acronym for the criteria in English, the original language of the test, although it can also be obtained with a rough translation into Spanish: A in appearance (or “appearance”), P in dust (“catch”), G in gesticulating “Grimace” , which literally means “grimace”), A of activity (“activity”) and R of breathing (“breathing”).

      1. Skin color (appearance)

      The criterion “appearance” refers to the color of the baby’s skin. The normal tone is denoted with a 2; a bluish color on the limbs will be evaluated with a 1, while if the whole body has a pale blue appearance, the result will be 0.

      2. Heart rate (pulse)

      Heart rate is assessed using a stethoscope. Heart rate is considered adequate when it exceeds 100 beats per minute; 1 is given when the rate is lower, while 0 is reserved for cases where no cardiac activity is detected.

      3. Irritability reflects (gesture)

      The Irritability Criterion Reflected (“gestures” in the acronym) measures the baby’s response to bothersome physical stimuli, such as a pinch. 0 indicates no reflected irritability, 1 the presence of weak gestures, such as squinting or crying a little, and 2 encompasses strong responses such as coughing, sneezing, or loud crying.

      4. Muscle tone (activity)

      In this case, a score of 2 is given when muscle tone is high and the baby is actively moving. A 1 means that muscle activity is low and a 0 means that the muscular system is in a relaxed and relaxed state.

      5. Respiratory effort (breathing)

      A score of 2 on this criterion indicates that the baby is crying normally. If breathing is slow or irregular, you will be assigned a 1, while a 0 means you are not breathing on your own.

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