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    Patent Pending

    APGAR Score

    Assesses neonates 1 and 5 minutes after birth.
    When to Use
    Pearls/Pitfalls
    Why Use

    Perform on every live newborn, regardless of GA, at 1 and 5 minutes of life.

    • 60 seconds after complete delivery of the newborn was deemed the point of most marked depression.
    • Per Neonatal Resuscitation Program (NRP), scoring continues at 5 minute intervals until reaching a score of 7 or until 20 minutes of life is encountered.
    • Scored by any provider with direct patient contact at the specified time.
    • The APGAR Score was developed to provide a simple and reliable grading scheme of newborns to communicate effects of obstetrical practices, maternal analgesia, and resuscitative efforts.
    • 5 objective signs were chosen for easy determination without interfering in patient care.
    • It should NOT be used to predict individual risk of mortality and adverse neurologic outcome.
    • Gestational age (GA), maternal sedation, congenital malformations, trauma, inter-observer variability may affect APGAR scoring.
    • Convenient and validated method to report status of a newborn and response to resuscitation.
    • Simple to teach in the delivery room. 1958 Second Report used ratings of house officers, nurses, and medical/nursing students.
    • Reliable to use, as variability between independent raters was minimal.
    • Useful in preterm and term newborns.
    • Corroborated by biochemical lab data.
    Active
    +2
    Some extremity flexion
    +1
    Limp
    0
    ≥100 BPM
    +2
    <100 BPM
    +1
    Absent
    0
    Sneeze/cough
    +2
    Grimace
    +1
    None
    0
    All pink
    +2
    Blue extremities, pink body
    +1
    Blue/pale
    0
    Good/crying
    +2
    Irregular/slow
    +1
    Absent
    0

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Virginia Apgar

    About the Creator

    Virginia Apgar, MD, (d. 1974) was an obstetrical anesthesiologist. Her eponymous score was the first to rate baby health at the time of birth. Through work at the March of Dimes, she was the first to shine light on the problem of premature birth. She was the first woman to be named Full Professor at Columbia University’s College of Physicians and Surgeons and is famously credited as saying that “women are liberated from the time they leave the womb.”

    To view Dr. Virginia Apgar's publications, visit PubMed

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    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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