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Apgar score

Dr Abhilash Sandhyala and Dr Frank Gaillard et al.

The Apgar score was originally described by Virginia Apgar (American anaesthesiologist, 1909-1974) in 1952.

Helpfully, her surname is also a useful mnemonic for remembering the 5 factors: each is graded as 0, 1 or 2 with a total possible score of 10. The lower the score the worse the prognosis.

The test is performed immediately after birth and then at 5 minutes. A low score initially may simply indicate the the neonate requires medical attention, whereas the latter at 5 minutes is assocaited with a poor prognosis.

Appearance (skin colour)

  • 0 : central cyanosis
  • 1 : peripheral cyanosis (acrocyanosis)
  • 2 : no cyanosis

Pulse

  • 0 : absent
  • 1 : <100
  • 2 ; >100

Grimace

  • 0 : no response to stimulation
  • 1 : grimace / feeble cry when stimulated
  • 2 : sneeze / cough / pulls away when stimulate

Activity (muscle tone)

  • 0 : none
  • 1 : some flexion
  • 2 : active movement

Respiration

  • 0 : absent
  • 1 : weak or irregular
  • 2 : strong

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