Chart of Apgar Score: Know the Value and Meanings

image001The Apgar score was devised by an anesthesiologist, Virginia Apgar, MD, in 1952, to evaluate the newborn baby's health right after birth. The Apgar score chart gives a quick and simple summary of the effects of anesthesia and childbirth, using five criteria that are simple to understand.

Apgar Score Chart: What Is It?

This scoring system is the first test given to every newborn in the delivery room after birth. The Apgar score is a quick evaluation of a baby's physical condition, which determines if there is immediate medical/emergency care needed. Dr Virginia Apgar designed the simple acronym APGAR to evaluate for A-Appearance, P-Pulse, G-Grimace, A-Activity, and R- Respiration.

The test is usually given twice: The first at one minute after birth, and then again at five minutes after her/his birth. Sometimes, concerns about a baby's poor condition or a low apgar score at 5 minutes merits doing the test again for the third time, at ten minutes after birth.

The procedure involves evaluating five factors regaring your baby's condition. Each factor gets a score of 0, 1 or 2. Two (2) is the best possible score for the following factors:

  • Appearance, which refers to the baby's skin coloration
  • Pulse, which refers to the heart rate
  • Grimace response, which medically refers to reflex irritability
  • Activity and tone of muscles
  • Respiration, which refers to the rate of breathing and effort

Doctors, nurses or midwives score each factor and add them together to get the baby's Apgar score. Scores, therefore, add up to 10 (the highest possible), but it may be as low as 0 (zero), indicating the baby's worst possible condition.

To understand what a baby's Apgar score means, use this simple Apgar score chart:

Sign / Degree

2

1

0

A - Activity

Active and spontaneous movements

Arms, legs flexed but little movement

Floppy tone, no movement

P - Pulse

Normal heartbeats (> 100 beats/min)

< 100 beats/min

Absent heartbeats
(no pulses)

G - Grimace

Baby sneezes, pulls away, coughs, cries upon stimulation

Facial movement (grimace) only upon stimulation

No response whatsoever to stimulation

A- Appearance

Normal color, pink hands and feet

Normal color, but bluish hands and feet

Pale or bluish-gray all over

R -Respiration

Good cry, normal rate of breathing

Weak cry, slow/ irregular breathing

No breathing

If you are interested in how the doctor carries on Apgar assessment, you can watch the video below:

What Do Apgar Scores Mean?

1. The One-minute Apgar Score

The doctor evaluates the baby one minute after birth to determine if she/he needs imminent medical attention. This constitutes the first or one-minute Apgar score. A score of 7 to 10 means that the baby is fine and does not need more than the usual care given to normal babies after delivery. There is no need to worry if your baby does not get a perfect score of 10, since most babies have bluish hands and feet at birth.

However, if she/he gets a score of 4 to 6, she may need mouth and nose suctioning some oxygen to help her/him breathe. A score of 3 or less indicates a need for resuscitation to save her/his life. A low 1-minute Apgar score is common among premature babies and some babies delivered via abdominal surgery (caesarean section), but this does not mean that your baby will not be fine eventually.

2. The Five-minute Apgar Score

The doctor evaluates the baby again after five minutes using the same scoring system to see how she/he is progressing. A 5-minute Apgar score of 7 to 10 is considered normal. However, if she/he scores a 6 or less during this time, she/he may need serious medical attention and further evaluation.