Apgar Scores | Romanucci & Blandin
In 1952, the Apgar score was created as a means to quickly assess how healthy a baby is after they are born. Dr. Apgar thought that the same signs that an anesthesiologist uses to monitor their patients during surgery could also be used to assess the health of a baby after birth and predict their chances of survival. The Apgar test is usually conducted between 1-5 minutes after the baby is born and it will be repeated if the baby continues to have a low score. The score is determined by an evaluation of the baby on five different criteria, given on a scale of 0 to 2 and then the scores are all added together. The five areas that are evaluated are:
- Appearance/ complexion
- Pulse rate
- Reflex irritability
- Respiratory effort
If the baby receives a score of 1-3, they are considered critically low. A score of 4-6 is considered to be below normal and anything above 7 is normal. If the baby receives a low score, it is very likely that they will need medical intervention. However, some criteria of the scores are subjective and a baby may still require medical treatment even if they received a normal score.
If a baby continues to have a low score 10-30 minutes after they are born, there is a chance that they will suffer from long-term neurological damage, which can increase the risk of cerebral palsy. However, even if the baby receives a high score, it does not mean that they will not suffer from a brain injury. The Apgar score is simply a quick means of seeing if the baby requires immediate medical care, but should not be used to make a long-term prediction of how healthy the baby will be later in life.
What Can Cause a Low Score?
If a baby was deprived of oxygen at any time during labor or delivery, or right after birth, it can cause them to receive a low score. There are several different conditions that can cause a low score, including:
- Amniotic fluid embolism
- Cardiorespiratory collapse in the mother
- Cephalopelvic disproportion
- Excessive vaginal bleeding
- Placental abruption
- Severe preeclampsia
- Shoulder dystoxia
- Trauma to the baby’s head if forceps or vacuum extractors were used to deliver the baby
- Umbilical cord problems, such as a prolapsed cord) or nuchal cord
- Undiagnosed or improperly treated maternal infections
- Uterine rupture,