APGAR Scores and Hypoxic Ischemic Encephalopathy (HIE)
The APGAR test is a test administered to all babies when they are born. It evaluates the baby’s general health by looking at five key parameters (1):
APPEARANCE:
This parameter looks at the baby’s skin color after birth. Physicians look to see if the baby is blue, pale or pink all over; or if the baby is blue at the extremities.
PULSE:
This portion of the score looks at the baby’s heart rate to decide if it is slow (<100 bpm), fast (>100 bpm), or absent.
REFLEX IRRITABILITY (GRIMACE):
This parameter tests the baby’s response to stimulation. Doctors decide whether the baby has: A) no response to stimulation; B) responds with a feeble cry or grimace; C) cries and pulls away from the stimulation.
ACTIVITY:
This evaluation tests the baby’s activity and movement, including activity and flexion (joint movement).
RESPIRATORY EFFORT:
This step looks at the baby’s ability to breathe. Doctors assess whether the baby’s breathing is weak and irregular, or regular, and whether the baby’s cry is strong.
APGAR tests are performed at one minute after birth and five minutes after birth; it is repeated if the score remains low after each of the first two tests. Each of the five areas is evaluated on a 0-2 point scale, and the points are added up to provide a quick overall indicator of the baby’s general health.
Scores Are Broken Down As Follows:
1-3 points: Critically low
4-6 points: Below normal
7+ points: Normal
If your baby’s APGAR score is low and remains low, it may indicate the infant has a brain injury like hypoxic ischemic encephalopathy (HIE). The lower the baby’s APGAR scores, the more likely it is that the baby will need doctors to provide medical intervention.
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