The APGAR test is a rapid assessment of newborn well-being, performed one and five minutes after birth. The first score assesses how the baby tolerated the birthing process, and the second assesses how the baby is doing outside the mother’s womb. The test examines the baby’s breathing effort, heart rate, muscle tone, reflexes, and skin color; scoring each category on a scale of 0 to 2, with 2 being the best score.
APGAR stands for:
Practitioners score each of the categories in the APGAR test and add them up, with 10 being the highest possible score. Scores of 2 in each category are given when the practitioner observes normal signs/behaviors; scores of 1 are given when lower than normal signs are observed; and scores of 0 are given when signs are absent or abnormal.
|Appearance (skin color)||Normal pink color all over, including in the hands and feet||Normal pink color all over except for the hands and feet, which may be bluish||Blue or grey color, or pale all over|
|Pulse (heart rate)||Normal (over 100 beats per minute)||Lower than 100 beats per minute||No pulse|
|Grimace response (reflex)||Pulls away, coughs, sneezes, or cries with stimulation||Facial movement only with stimulation||No response to stimulation|
|Activity (muscle tone)||Active movement||Little movement||No movement|
|Respiration (breathing rate and effort)||Good cry, normal breathing rate and effort||Weak cry, slow or irregular breathing||No breathing|
Potential causes of a low APGAR score may include:
A healthy APGAR score ranges from 7 to 10. APGAR scores between 4 and 6 indicate that some medical intervention may be required. Scores under 4 may indicate severe respiratory distress, calling for lifesaving measures. For infants with a score less than 7, the test is performed at five-minute intervals until the 20-minute mark. The APGAR score offers medical practitioners a prompt way to determine if intervention is needed to help the infant breathe.
APGAR score interpretation helps professionals to determine the immediate well-being of a baby. It does not predict neonatal mortality, neurologic outcome, nor the future health of the child. Lower scores do not always correlate to permanent health problems, and similarly, higher APGAR scores do not rule out the possibility of brain damage, such as hypoxic-ischemic encephalopathy (HIE).
However, if the APGAR score is low at 10, 15, or 30 minutes after birth, there is a higher risk that the baby will suffer long-term brain damage, cerebral palsy, and/or seizure disorders. In these cases, babies require immediate medical attention.
Aside from the APGAR test, practitioners may also administer a Ballard Maturational Assessment (also known as New Ballard Score), which is a commonly used technique to assess gestational age. Doctors will assess a newborn based on several characteristics (physical and neuromuscular) to evaluate the accuracy of the baby’s gestational age, down to 20 weeks gestation. The Downe’s Score and the Silverman Anderson Score are methods doctors may use to determine respiratory distress in a newborn.
If your child received a low APGAR score and suffers from birth injuries, it may be a result of medical malpractice. Please contact us at 877-262-9767 to speak with one of our birth injury lawyers.
The following reviews from our clients do not constitute a guarantee, warranty, or prediction regarding the outcome of another legal matter. The cases mentioned in the reviews are illustrative of some of the matters previously handled by Grant & Eisenhofer involving various areas of birth injury law. These reviews are endorsements.