Virginia Apgar

If you ask a mother or a father what is his/her best moment in life, the answer comes in most cases, the moment when they touches their babies for the first time. It is really amazing that none can explain but just great. There is a big preface behind this happiness, evaluating an infant's health at birth based on appearance, heart rate, reflex irritability, muscle tone, and respiration.

 

Australian physician Virginia Apgar Invented a process in 1952 titled 'Apgar Score', a system to test the health of the newborn infants by delivery room personnel. This test helps to determine whether a newborn needs help breathing or is having heart trouble. Apgar was an early expert in the area of birth defects. The test enables medical staff to quickly assess a newborn's condition and initiate treatment if necessary.

 

What is Apgar Score

 

'Apgar score' is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb. In rare cases, the test will be done 10 minutes after birth. It also known as 'Newborn scoring' and 'Delivery - Apgar'.

 

The Apgar score is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth. A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth. Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjust outside the mother's womb.

Virginia Apgar was born on June 7 of 1909 in Westfield, a town in Union County, New Jersey in United States. In 2018 Google Doodle celebrated Dr. Virginia Apgar as a pioneering American doctor who gave the world a still-used system for quickly assessing the health of newborns.

 

Ms. Virginia decided to be a doctor after graduating from high school. She entered the College of Physicians and Surgeons at Columbia University before the Wall Street crash of October 1929, the beginning of the Great Depression. Despite financial problems, she graduated fourth in her class in 1933 and won a surgical internship at Columbia and performed brilliantly. But she get discouraged by the chair of surgery, Dr. Alan Whipple, from continuing because of the failure of other women he had trained in surgery, establishing successful careers in the specialty.

 

Anesthesiology was not generally recognized as a specialty until the mid-1940s, Apgar struggled a lot to find a training program when after completing her surgical residency in 1937. There she took a six months training with Dr. Ralph Waters' department of anesthesia, the first in the United States, at the University of Wisconsin-Madison.

 

Virginia began studying obstetrical anesthesia, the effects of anesthesia given to a mother during labor on her newborn baby. Apgar wasn't only pioneering in her field of research, she also took strides for women. She was the first woman to became a full professor at Columbia University College of Physicians and Surgeons, even the director of the school's anesthesiology department. She designed the newborn's transition to life outside the womb. The Apgar test enables medical staff to quickly assess a newborn's condition and initiate treatment if necessary.

She was a leader in the fields of anesthesiology and teratology, and effectively founded the field of neonatology. Dr. Virginia Apgar did not fear a challange. An anesthesiologist by training, she climbed the ranks at New York's Columbia-Presbyterian Hospital in the 1930's and 40's, when anesthesiology wasn't recognized as a medical specialty. In 1949, she moved onto neonatal medicine, where she began to dedicate herself to saving the lives of babies.

How the Apgar Score Test is Performed

 

The Apgar test is done by a doctor, midwife, or nurse. The provider examines the baby's:

 

_Breathing effort
_Heart rate
_Muscle tone
_Reflexes
_Skin color

 

Each category is scored with 0, 1, or 2, depending on the observed condition.

 

Breathing effort:

 

_If the infant is not breathing, the respiratory score is 0.
_If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
_If the infant cries well, the respiratory score is 2.

 

Heart rate is evaluated by stethoscope. This is the most important assessment:

 

_If there is no heartbeat, the infant scores 0 for heart rate.
_If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
_If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.

 

Muscle tone:

 

_If muscles are loose and floppy, the infant scores 0 for muscle tone.
_If there is some muscle tone, the infant scores 1.
_If there is active motion, the infant scores 2 for muscle tone.

 

Grimace response or reflex irritability is a term describing response to stimulation, such as a mild pinch:

 

_If there is no reaction, the infant scores 0 for reflex irritability.
_If there is grimacing, the infant scores 1 for reflex irritability.
_If there is grimacing and a cough, sneeze, or vigorous cry, the infant scores 2 for reflex irritability.

 

Skin color:

 

_If the skin color is pale blue, the infant scores 0 for color.
_If the body is pink and the extremities are blue, the infant scores 1 for color.
_If the entire body is pink, the infant scores 2 for color.

 

Reference: cfmedicine , NewsWeek, Medlineplus