Why is apgar performed twice

The Law Firm of Michael H. Bereston represents birth injury, medical malpractice, and personal injury cases. As a nationwide birth injury attorney, we offer free, confidential consultations to clients seeking assistance.

If your child is experiencing the signs of cerebral palsy, contact a nationwide birth injury attorney to discuss your options for financial compensation so your family can rebuild. The Law firm of Michael H. Bereston is devoted to seeking justice and a hopeful future for you and your family, contact us today at to learn more. Michael H. Bereston Jun 14, P ulse Rate Measuring pulse rate heart rate is an important aspect in determining an infant's health.

The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby's condition, the test may be given again.

In the test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score:. Doctors, midwives , or nurses add up these five factors for the Apgar score. So rather than focusing on a number, just enjoy your new baby! Note: All information on KidsHealth is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. All rights reserved.

Find a Doctor. About Us. Community Programs. California Kids Care. International Services. Video Visits: Telemedicine. Locations Main Campus. The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia, does not predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose.

An Apgar score assigned during a resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions. In , Dr. Virginia Apgar devised a scoring system that was a rapid method of assessing the clinical status of the newborn infant at 1 minute of age and the need for prompt intervention to establish breathing 1.

A second report evaluating a larger number of patients was published in 2. This scoring system provided a standardized assessment for infants after delivery. The Apgar score comprises five components: 1 color, 2 heart rate, 3 reflexes, 4 muscle tone, and 5 respiration, each of which is given a score of 0, 1, or 2.

Thus, the Apgar score quantitates clinical signs of neonatal depression such as cyanosis or pallor, bradycardia, depressed reflex response to stimulation, hypotonia, and apnea or gasping respirations.

The score is reported at 1 minute and 5 minutes after birth for all infants, and at 5-minute intervals thereafter until 20 minutes for infants with a score less than 7 3. The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed; however, it has been inappropriately used to predict individual adverse neurologic outcome.

The purpose of this statement is to place the Apgar score in its proper perspective. However, resuscitation must be initiated before the 1-minute score is assigned.

Therefore, the Apgar score is not used to determine the need for initial resuscitation, what resuscitation steps are necessary, or when to use them 3. An Apgar score that remains 0 beyond 10 minutes of age may, however, be useful in determining whether continued resuscitative efforts are indicated because very few infants with an Apgar score of 0 at 10 minutes have been reported to survive with a normal neurologic outcome 3 4 5. Neonatal Encephalopathy and Neurologic Outcome , Second Edition, published in by the College in collaboration with the AAP, defines a 5-minute Apgar score of 7—10 as reassuring, a score of 4—6 as moderately abnormal, and a score of 0—3 as low in the term infant and late-preterm infant 6.

However, a persistently low Apgar score alone is not a specific indicator for intrapartum compromise. Further, although the score is used widely in outcome studies, its inappropriate use has led to an erroneous definition of asphyxia. Asphyxia is defined as the marked impairment of gas exchange leading, if prolonged, to progressive hypoxemia, hypercapnia, and significant metabolic acidosis.

The term asphyxia, which describes a process of varying severity and duration rather than an end point, should not be applied to birth events unless specific evidence of markedly impaired intrapartum or immediate postnatal gas exchange can be documented based on laboratory testing 6. It is important to recognize the limitations of the Apgar score.

There are numerous factors that can influence the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and interobserver variability 6. In addition, the biochemical disturbance must be significant before the score is affected.