The Apgar scale is a measure for evaluating the condition of a newborn baby. The five test criteria Appearance, Pulse, Grimace, Activity, and Respiration form an acronym named after Virginia Apgar who first introduced this type of testing on newborns in 1953.

The five categories in the Apgar Scale (or Apgar Test) are evaluated
using the following criteria:


_______________________________________________________________________________________
SIGN                                     POINTS

                            0                     1                2  
_______________________________________________________________________________________
Appearance*            Pale or Blue           Body pink:        Pink
(color)                                       extremities blue

Pulse                  Not detectable         Below 100         Over 100  
(heartbeat)

Grimace                No response to         Grimace           Lusty cry  
(reflex irritability)  stimulation

Activity               Flaccid                Some movement     A lot of  
(muscle tone)          (no or weak activity)  of extremities    activity

Respiration            None                   Slow, irregular   Good  
(breathing)                                                     (crying)
_______________________________________________________________________________________
*In non-white children, color of mucus membranes of mouth, of the
whites of the eyes, of lips, palms, hands and soles of feet will be
examined. 

Babies whose score is between 7 and 10 are considered to be in good
condition. Those scoring between 4 and 6 are in fair condition and may
require extra attention. Those with a score below 4 are in poor
condition and probably will need immediate life-saving efforts.

Limitations of the Apgar score:

While we all want our babies to be a perfect 10, an Apgar score of 10 at 1 minute reflects an overly generous scorer more than the condition of the baby. Almost all babies have bluish feet and hands at birth and for several minutes (to hours) thereafter.

The 1 and 5 minute Apgar scores are just a picture of the baby's condition within a window of time. They do not accurately predict long-term outcomes. A low 10 minute Apgar score (babies with low 1 and 5 minute scores are commonly tested again at 10 minutes) does predict long-term outcomes somewhat but is still unreliable.

Scoring is subjective and susceptible to scorer bias. The person caring for the mother tends to give a higher score. The person caring for the infant tends to score lower.

Apgar scores are inappropriately used to evaluate the health care provided in medical malpractice cases, thus perpetuating use of a fudge factor when scoring.

The Apgar score is even less useful for premature babies who are naturally floppy and may have low scores yet have no asphyxia. This means the score’s value as a tool to predict the need for immediate resuscitation in prematures is limited.

So, if your little angel scored a perfect 10 don't count on merit based scholarships based on that fact alone and if s/he scored a 7 you still need to start that college fund.

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