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Baby Apgar test: administration mode and criteria

Baby Apgar test: administration mode and criteria

September 29, 2022

The Apgar test is a test that applies to babies who have just been born. It consists in assessing your physical condition in five large areas to determine if you need medical assistance.

In this article we will describe the five criteria of the Apgar test and its mode of administration . It is worth bearing in mind that, although it is a useful test, its results are superficial and it is important to complement them with other exams in greater depth.

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What is the Apgar test?

It is very common to have evaluation tests soon after delivery to check if the baby reacts normally to different types of stimulation and if your nervous system is functioning properly.


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

The objective of this test is to determine the degree of perinatal stress suffered by the baby to assess whether he needs medical assistance or can survive without outside help, taking these five criteria as a basic reference.

Other tests used to assess the status of neonates are the Prechtl test, which also evaluates posture, spontaneous movements or facial expressions, and the Brazelton Neonatal Behavior Assessment Scale , whose criteria include social interaction, muscle capacity, control of alertness and the physiological response to stress.


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Administration mode

The Apgar test is applied by medical or nursing staff one minute after birth, and again happens after five minutes of delivery . In this way you can get a general and quick idea of ​​the state of the baby, although the information provided by this test is limited since it only detects obvious complications.

The five variables that we have mentioned (and which we will describe in detail in the next section) are scored from 0 to 2; While the minimum assessment is an indication of the existence of very serious problems in this area, 2 indicates a 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 baby; if it is less than 4, the small one will require urgent medical attention, while if it is between 4 and 7, a more detailed evaluation will have to be made.


Apgar exam criteria

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

The term "Apgar" is an acronym of the criteria in English, the original language of the test, although it can also be obtained with an approximate translation in Spanish: A of appearance (or "appearance"), P of pulse ("pulse"), G of gesticulation ("grimace", which literally means "grimace"), A of activity ("activity") and R of respiration ("respiration").

1. Skin color (Appearance)

The "appearance" criterion refers to the color of the baby's skin. The normal tone is scored with a 2; A bluish color on the extremities will be assessed with a 1, while if the whole body has a pale and blue appearance the result will be 0.

2. Heart rate (Pulse)

The heart rate is assessed by the use of a stethoscope. It is considered that the heart rate is adequate when it exceeds 100 beats per minute ; 1 is granted when the frequency is lower, while 0 is reserved for cases in which cardiac activity is not detected.

3. Reflex irritability (Gesturing)

The criterion of reflex irritability ("gesticulation" in the acronym) measures the baby's response to annoying physical stimuli, such as a pinch. The 0 indicates an absence of reflex irritability, 1 the presence of weak gestures, such as frowning or crying a little, and the 2 includes energetic responses such as coughing, sneezing or loud crying.

Four.Muscle tone (Activity)

In this case, a score of 2 is awarded when muscle tone is high and the baby moves actively . A 1 means that muscle activity is weak, and a 0 that the muscular system is in a state of flaccidity and laxity.

5. Respiratory effort (Breathing)

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


FTCA Risk Management: Right On Time Safe and Timely Delivery of Neonates (September 2022).


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