apgar score

Radiopaedia • CC-by-nc-sa 3.0 • de

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 neonate requires medical attention, whereas the latter at 5 minutes is associated with a poor prognosis.

Appearance (skin color):

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

Pulse:

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

Grimace:

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

Activity (muscle tone):

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

Respiration:

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