Written by Timothy Okooboh
After the birth of a child, it’s very important to know his or her health status before leaving the hospital. There’s a very easy and effective way of immediately assessing the health of a newborn. This is the Apgar score. It’s a life-saving method introduced by Dr. Virginia Apgar in 1952; however, it remains valid till date. Since its inception, the Apgar score has helped to save the lives of many babies. Unfortunately, some child health workers either don’t know about it or fail to apply it after the birth of a baby. This article clearly explains the importance of the Apgar score and the need for every parent to always ensure the score is performed for their newborn.
What is the Apgar score?
Apgar stands for Appearance (skin color), Pulse (heart rate), Grimace (reflexes), Activity (muscle tone), and Respiration (breathing rate and effort). It is used to assess the health of a newborn and determines if immediate medical care is needed. A baby’s health is evaluated based on the 5 Apgar signs at 1 minute and 5 minutes after birth; the test may be repeated severally if the score is low at 5 minutes. A score of 0, 1 or 2 is given to each sign. Therefore, the total maximum score possible is 10. A total score of 0 to 3 is critically low and requires emergency medical care. A total score of 4 to 6 is fairly low. A total score of 7 to 10 is normal.
Consider the table below obtained from KidsHealth. It explains the Apgar score in detail.
|Apgar Sign||Score of 2||Score of 1||Score of 0|
|Normal color all over (hands and feet are pink)||Normal color (but hands and feet are bluish)||Bluish-gray or pale all over|
|Normal (above 100 beats per minute)||Below 100 beats per minute||Absent
|Pulls away, sneezes, coughs, cries with stimulation||Facial movement only (grimace) with stimulation||Absent (no response to stimulation)|
|Active, spontaneous movement||Arms and legs flexed with little movement||No movement, “floppy” tone|
(breathing rate and effort)
|Normal rate and effort, good cry||Slow or irregular breathing, weak cry||Absent (no breathing)
Why is Apgar score important?
The Apgar score can save the life of a baby. If a baby has a low score, it’s a sign that immediate medical attention is needed. Now imagine that the assessment is not carried out, how would the doctor know that the child is at risk of death or deformity? According to a 2017 UNICEF report, the largest number of newborn deaths occurred in Southern Asia (39 percent), followed by sub- Saharan Africa (38 percent). Five countries accounted for half of all newborn deaths: India, Pakistan, Nigeria, the Democratic Republic of the Congo and Ethiopia.
Risk of neonatal mortality is the possibility of a baby dying within 4 weeks of birth. Post-neonatal mortality is the risk of a baby dying after 4 weeks of birth.
Therefore, it’s very important that every newborn is assessed based on the Apgar score. Doctors should not ignore this. As a parent, ask for the result of the score and its interpretation, just to be sure it was done.
Some important things to consider
- Never deliver your baby at home or by an unqualified medical personnel. Otherwise, the child is at risk of death or harm as the Apgar score will not be performed.
- A child may have a low score at 1 minute but a better score at 5 minutes. However, a 1-minute score of 0 to 3 should not be ignored. It may indicate an immediate resuscitation of the baby.
- However, the resuscitation of a baby should start immediately after birth if it’s noticed that there’s no sign of life, instead of waiting for the result of the 1- minute Apgar score.
Putting it all together
- Apgar score is an easy and effective way of immediately assessing the health status of a newborn.
- It is performed at 1 and 5 minutes after birth.
- It involves observing the appearance (color), pulse (heart rate), grimace (reflexes), activity (muscle tone) and respiration of a baby.
- A very low score is a sign that the child requires urgent medical care. Therefore, Apgar score can save the life of a baby and reduces the risk of a defect, if the child is treated quickly.
- Therefore, parents should ensure the score is carried out for their newborn. Also, mothers should avoid giving birth at home or by an unqualified personnel.
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