SN2
SHORT NOTE
5M
★ High-yield
Write a short note on APGAR Score.
Definition
- The Apgar score is a rapid, standardised method (devised by Dr Virginia Apgar in 1953) of assessing a newborn's clinical condition and response to resuscitation at birth.
- Five signs are each scored 0, 1 or 2, giving a total of 0–10.
The Five Parameters (mnemonic 'apgar')
| Sign | 0 | 1 | 2 |
|---|---|---|---|
| A — Appearance (colour) | Blue / pale all over | Body pink, extremities blue (acrocyanosis) | Completely pink |
| P — Pulse (heart rate) | Absent | < 100/min | > 100/min |
| G — Grimace (reflex irritability) | No response | Grimace / weak cry | Cough, sneeze, cry |
| A — Activity (tone) | Limp | Some flexion | Active motion |
| R — Respiration | Absent | Slow, irregular, weak cry | Good, strong cry |
Timing & Interpretation
- Recorded at 1 minute and 5 minutes; if the 5-minute score is < 7, it is repeated every 5 minutes up to 20 minutes.
- 7–10 = normal; 4–6 = moderate depression; 0–3 = severe depression.
- An expanded Apgar form also documents the concurrent resuscitation (O2, PPV, CPAP, intubation, compressions, adrenaline).
Clinical Significance
- Provides a common, reproducible language to describe a newborn's condition at birth.
- Helps in documentation and communication among the resuscitation team.
- Serial scores reflect the response to resuscitative efforts.
Limitations
- Never used to decide whether or when to start resuscitation — resuscitation is guided by respirations and heart rate and must not be delayed to assign a score.
- Affected by prematurity, maternal sedation / anaesthesia, neuromuscular disease and congenital anomalies.
- A single low score does not by itself diagnose asphyxia or reliably predict long-term outcome.
- Subjective and shows inter-observer variation.
It assesses response to resuscitation — it does not dictate starting it.
All questions in Neonatology
- Q1Discuss Neonatal Resuscitation — its causes, clinical features and management. ★
- Q2Describe the approach, Causes & Management of Neonatal Jaundice. ★
- Q3Define Neonatal Sepsis. Describe its pathogenesis, classification, clinical features and investigations. ★
- Q4Define Respiratory Distress in Newborn & Hyaline Membrane Disease. Describe its causes, pathophysiology, clinical features and investigations. ★
- Q5Define Perinatal (Birth) Asphyxia & Hypoxic-Ischaemic Encephalopathy. Describe its aetiology, pathophysiology, investigations and management. ★
- SN1Write a short note on Kangaroo Mother Care. ★
- SN2Write a short note on APGAR Score. ★
- SN3Define Neonatal Hypoglycaemia. Describe its aetiology, clinical features and management. ★
- SN4Define Meconium Aspiration Syndrome. Describe its pathophysiology, clinical features, investigations and management.
- SN5Define Retinopathy of Prematurity. Describe its pathogenesis, classification and management.
- SN6Write a short note on Essential (Care of Normal) Newborn Care. ★
- SN7Define Neonatal Hypothermia & Cold Injury. Describe its clinical features and management.