Within the first minutes of life, every newborn is given an Apgar score, which provides a quick assessment of how well the baby is doing outside the womb.
Developed in 1952 by Dr. Virginia Apgar, the test gives the delivery team a standardized analysis on a newborn’s condition and signals whether the baby needs immediate help.
An abnormal score is not a diagnosis, but it can be the first warning sign that something went wrong during labor or delivery.
What the Apgar Score Measures
The score is taken at one minute and again at five minutes after birth. It rates five signs, each from 0 to 2, for a total between 0 and 10.
The five categories are:
- Appearance (skin color). Blue or pale all over scores 0. A pink body with blue hands and feet scores 1. Fully pink scores 2.
- Pulse (heart rate). No heartbeat scores 0. Under 100 beats per minute scores 1. 100 or more scores 2.
- Grimace (reflex response). No reaction to stimulation scores 0. A grimace scores 1. Crying or pulling away scores 2.
- Activity (muscle tone). Limp scores 0. Some bending of the limbs scores 1. Active movement scores 2.
- Respiration (breathing). No breathing scores 0. Weak or irregular breathing scores 1. A strong cry scores 2.
A score of 7 to 10 is considered normal and reassuring. A score of 4 to 6 is moderately low and usually means the baby needs some assistance, such as oxygen or stimulation. A score of 0 to 3 is critically low and calls for immediate resuscitation.
What Causes a Low Apgar Score
A low score at one minute is common and often improves quickly. A score that stays low at five and ten minutes is more concerning, because it suggests the baby is not recovering and may be deprived of oxygen.
Several conditions can drive a score down, including:
- Oxygen deprivation during labor or delivery
- Umbilical cord problems, such as compression or prolapse
- Placental abruption or other placental issues
- A prolonged or difficult delivery
- Premature birth
- Infection
- Excessive maternal sedation or anesthesia
- Fluid or meconium in the baby’s airway
A low score due to these or other issues generally requires immediate medical intervention.
When a Low Score May Signal Malpractice
A low Apgar score by itself does not prove negligence; many babies with early low scores go on to be perfectly healthy. However, if the score reflects a preventable injury, particularly oxygen deprivation that the medical team should have caught and addressed, malpractice could be an issue.
Failing to monitor fetal distress, delaying a necessary cesarean, or mishandling the delivery can all lead to a dangerously low score and lasting harm. If your child had an abnormal Apgar score and later showed signs of a birth injury, you should consider consulting a Houston birth injury attorney.
An attorney can review the delivery records and explain whether the birth injury may have been caused by malpractice. Contact Hampton & King today for a free consultation.