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Apgar Score: Methods Used To Evaluate Newborn Condition

This scoring system is a useful clinical tool to identify those neonates who require resuscitation as well as to assess the effectiveness of any resuscitative measures. As shown in Table below, each of the five easily identifiable characteristics—heart rate, respiratory effort, muscle tone, reflex irritability, and color—is assessed and assigned a value of 0 to 2. The total score, based on the sum of the five components, is determined 1 and 5 minutes after delivery. 

Apgar Scoring System
0 Points
1 Point
2 Points
Heart rate
< 100 bpm
100 bpm
Respiratory effort
Slow, irregular
Good, crying
Muscle tone
Some flexion of extremities
Active motion
Reflex irritability
No response
Vigorous cry
Blue, pale
Body pink, extremities blue
Completely pink

The 1-minute Apgar score reflects the need for immediate resuscitation. The 5-minute score, and particularly the change in score between 1 and 5 minutes, is a useful index of the effectiveness of resuscitative efforts. The 5-minute Apgar score also has prognostic significance for neonatal survival, because survival is related closely to the condition of the neonate in the delivery room.

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