The Apgar score is a subjective assessment of the baby at birth, and at 1, 5, and 10 minutes following birth. Five things are assessed, each being scored out of 2, for a total possible score of 10. The heart rate,respiratory effort ,muscle tone, response to stimuli and colour are each given a score between 0 and 2. A score of 7 to 10 is regarded as a good score. A score of 3 to 6 requires intervention with a mask and an airway in the mouth.
Apgar of 0 to 2 indicates that acute resuscitation is required. A more objective way of assessing the fetus at birth is to examine the arterial and venous blood cord gases taken from the blood vessels of the placenta shortly after delivery. These give us a far more objective insight as to how the baby was at birth in terms of distress or fatigue.
The blood gases take a while to process and also require a blood gas machine being available. The newer neonatal resuscitation criteria do not advocate waiting 60 seconds for an Apgar score to determine if there is a need to intervene. The Apgar score is still recorded, but it is not useful for resuscitation purposes and it is not an accurate measure of how well the baby was at birth. It is more of a subjective measure.
