Apgar score

A (appearance)

Skin color / oxygenation

no cyanosis body and extremities pink +2
blue at extremities body pink (acrocyanosis) +1
blue or pale all over 0

P (pulse)

Strength and regularity of heart rate

> 100 beats per minute +2
< 100 beats per minute +1
absent 0

G (grimace)

Reflex response to irritable stimuli

cry on stimulation +2
grimace on suction or aggressive stimulation +1
no response to stimulation 0

A (activity)

Muscle tone and movement

flexed arms and legs that resist extension +2
some flexion +1
none 0

R (respiration)

Lung maturity

strong, lusty cry +2
weak, irregular, gasping +1
absent 0

Skin color / oxygenation

Strength and regularity of heart rate

Reflex response to irritable stimuli

Muscle tone and movement

Lung maturity


7-10 - generally normal
4-6 - fairly low
0-3 - critically low level

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