How Dr Virginia Apgar saved the lives of thousands of babies with the Apgar score

Victoria Woollaston June 7, 2018

Dr Virginia Apgar, the pioneering anaesthesiologist who developed the life-saving Apgar score, is being celebrated in today’s Google Doodle.

How Dr Virginia Apgar saved the lives of thousands of babies with the Apgar score

Dr Virginia Apgar: Who was she?

On what would have been her 109th birthday, and almost 44 years after her death, Dr Virginia Apgar is credited with saving the lives of thousands – if not millions – of babies with the first standardised method of assessing a newborn’s health.

While working in New York in the mid 1930s, Dr Virginia Apgar reported that she was horrified at how newborn babies were assessed, with many being left to die uncessarily. At that time, babies who were born with malformations or had troubled breathing were often listed as stillborn and left to die.

What is the Apgar score?

The original Apgar score, which is both named after Dr Virginia Apgar as well as being an acronym for the five stages of the test, looks for various signifiers of health and children born today are given a rating out of 10, based on their condition. This overall score is based on each individual factor being scored between zero and two.

The five stages are Appearance, Pulse, Grimace, Activity and Respiration.

Apgar Sign	2	1	0
Appearance (skin colour)	Normal colour all over (hands and feet are pink)	Normal colour (but hands and feet are bluish)	Blueish-grey or pale all over
Pulse (heart rate)	Normal (above 100 beats per minute)	Below 100 beats per minute	Absent (no pulse)
Grimace (“reflex irritability”)	Pulls away, sneezes, coughs, or cries with stimulation	Facial movement only (grimace) with stimulation	Absent (no response to stimulation)
Activity (muscle tone)	Active, spontaneous movement	Arms and legs flexed with little movement	No movement, “floppy” tone
Respiration (breathing rate and effort)	Normal rate and effort, good cry	Slow or irregular breathing, weak cry	Absent (no breathing)

Source: KidsHealth

Dr Virginia Apgar first devised the scoring system in 1952, and it has been used in nearly every hospital birth since, typically being given twice – once at one minute after birth, and again five minutes later. This is to give doctors or midwives to resuscitate, if necessary, or give the baby chance to adjust to being out of the womb. Few babies get a score of 10, often because it takes time for their skin to warm up and their reflexes to settle, but a score of seven or above is considered a sign of good health. Some babies are given lower scores initially but go on to be perfectly healthy.

According to Google, writing in a blog post about the Doodle, Dr Virginia Apgar’s work helped reduced the death rate for newborns in the US from one in 30 in the 1950s, to one in 500 today.

Beyond the Apgar score, Dr Virginia Apgar was the first woman to become a full professor at the Columbia University College of Physicians and Surgeons, and was the director of the school’s department of anesthesiology. She also played a fundamental role in research into the prevention of birth defects as a director at the National Foundation for Infantile Paralysis.

“Today, on what would’ve been her 109th birthday, we celebrate a woman whose incredible life’s work continues to touch – and sometimes save – brand new lives every day,” continued Google.