APGAR

SCORING
HELENITA ARLENE M. MOROS
ASSOCIATE PROFESSOR V
BICOL UNIVERSITY
What does APGAR stand for, and what does it measure?
When the scoring system was put into common use, medical
professionals created an acronym using Apgar’s last name, so that
each criterion included in the assessment would be easier to
remember. The five criteria assessed in the Apgar score are:
 A – Appearance (skin color)
This is an evaluation of the baby’s skin color. The
medical team measures if the baby blue or pale all
over, blue at the extremities, or pink all over.
 P – Pulse (heart rate)
During this evaluation, the medical team
measures if the baby’s heart rate is absent,
slow (<100 beats per minute (bpm), or fast
(>100 bpm).
 G – Grimace (reflex irritability/response)
During this evaluation, the medical team asks if the baby lacks a response to
stimulation, responds with a grimace, or responds by crying and pulling
away.
A – Activity (muscle tone)
During this evaluation, the medical team asks if the baby is limp, if the baby
has some flexion (joint movement), or if the baby shows active motion.
R – Respiration (breathing ability)
During this step, the medical team asks if the baby is failing to breathe, if the
baby has a weak cry and slow breathing, or if the baby is breathing well and
crying normally (1).
 When is Apgar testing done?
 Apgar testing is typically done at one and five minutes
after a baby is born, and it may be repeated at 10, 15, and
20 minutes if the score is low. The five criteria are each
scored as 0, 1, or 2 (two being the best), and the total score
is calculated by then adding the five values obtained (1).
 What do Apgar scores mean?
 What do Apgar scores mean?
 Apgar scores of 0-3 are critically low, especially in term
and late-preterm infants
 Apgar scores of 4-6 are below normal, and indicate that
the baby likely requires medical intervention
 Apgar scores of 7+ are considered normal (1, 3)
 The lower the Apgar score
 The Apgar test is done by a doctor, midwife, or nurse
 The provider examines the baby’s:
1. Breathing effort
2. Heart rate
3. Muscle tone
4. Reflexes
5. Skin color
• Each category is scored with 0, 1, or 2, depending on the observed
condition
BREATHING EFFORT
IF THE INFANT IS NOT
BREATHING THE
RESPIRATORY SCORE IS 0.
IF RESPI IS SLOW OR
IRREGULAR-SCORE IS 1.
IF INFANT CRIES- 2
HEART RATE- USE A
STETHOSCOPE
NO HEARTBEAT-0
HR<100 BPM- 1
HR > 100- 2
MUSCLE TONE- MUSCLES
LOOSE AND FLUFFY- 0
SOME TONE- 1
ACTIVE MOTION- 2
REFLEX IRRITABILITY-
RESPONSE TO STIMULATION
NO REACTION- 0
GRIMACING- 1
GRIMACE, COUGH SNEEZE- 2
SKIN COLOR-
PALE BLUE- 0
BODY PINK, EXTREMITIES
BLUE- 1
ENTIRE BODY PINK - 2
ADD UP THE FINDINGS IN
EACH CATEGORY EQUALS
THE APGAR SCORE OF THE
INFANT
 pgar test (although higher scores do not necessarily indicate a lack of oxygen-deprivation).
Listed below are just a few of the complications that can cause a baby to become oxygen-
deprived, and may manifest in low Apgar scores:
 C-Section errors and delays
 Fetal monitoring errors
 Infections
 Maternal medical conditions
 Placental Abruption
 Preterm birth
 Prolonged and arrested labor
 Umbilical cord problems
 Uterine hyperstimulation/tachysystole (this can be caused by the delivery drugs Pitocin and 
Cytotec)
 Uterine rupture
ANTHROPOMETRIC MEASUREMENTS
As for the females, the average newborn weighed
3.11kg with a range of 2.1kg to
4.2kg, measured 48.49cm in length with a range of
45.1cm to 51.7cm and measured 34.16cm in head
circumference with a range of 32.3 to 36.4. These
values were found to be statistically significant
when compared with the WHO- MGR.
Age 50th percentile length for male 50th percentile length for female
babies babies

Birth 19.75 in (49.9 cm) 19.25 in (49.1 cm)

1 month 21.5 in (54.7 cm) 21.25 in (53.7 cm)

2 months 23 in (58.4 cm) 22.5 in (57.1 cm)

3 months 24.25 in (61.4 cm) 23.25 in (59.8 cm)

ntroduction. Anthropometric measurements are a
series of quantitative measurements of the muscle,
bone, and adipose tissue used to assess the
composition of the body. The core elements
of anthropometry are height, weight, body mass
index (BMI), body circumferences (waist, hip, and
limbs), and skinfold thickness.Apr 28, 2020