Document Detail


The Apgar score has survived the test of time.
MedLine Citation:
PMID:  15791116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 1953, Virginia Apgar, M.D. published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Virginia Apgar reviewed anesthesia records of 1025 infants born alive at Columbia Presbyterian Medical Center during the period of this report. All had been rated by her method. Infants in poor condition scored 0-2, infants in fair condition scored 3-7, while scores 8-10 were achieved by infants in good condition. The most favorable score 1 min after birth was obtained by infants delivered vaginally with the occiput the presenting part (average 8.4). Newborns delivered by version and breech extraction had the lowest score (average 6.3). Infants delivered by cesarean section were more vigorous (average score 8.0) when spinal was the method of anesthesia versus an average score of 5.0 when general anesthesia was used. Correlating the 60 s score with neonatal mortality, Virginia found that mature infants receiving 0, 1 or 2 scores had a neonatal death rate of 14%; those scoring 3, 4, 5, 6 or 7 had a death rate of 1.1%; and those in the 8-10 score group had a death rate of 0.13%. She concluded that the prognosis of an infant is excellent if he receives one of the upper three scores, and poor if one of the lowest three scores.
Authors:
Mieczyslaw Finster; Margaret Wood
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  102     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-25     Completed Date:  2005-05-16     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  855-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, College of Physicians and Surgeons, Columbia-Presbyterian Medical Center, 630 West 168th Street, New York, NY 10032, USA. mf16@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Anesthesiology / history*
Apgar Score*
History, 20th Century
Humans
Infant, Newborn / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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