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Limitations of the Apgar Score

Posted by Frank Piscitelli | Jan 21, 2020 | 0 Comments

Thanks to advancements in technology, the majority of Ohio babies are born without severe complications. However, when an issue does arise, it is imperative that the delivery room team understands how to handle the situation. If your child has health issues as a result of negligence at or near the time of birth, you may have grounds for a claim. 

According to the American College of Obstetricians and Gynecologists, Dr. Virginia Apgar developed a system to rapidly assess the clinical status of an infant beginning one minute after birth. The goal was to determine the need for breathing assistance. The standardized evaluation looks at five different factors. 

  • Appearance (skin color) 
  • Pulse (heart rate) 
  • Grimace (reflexes) 
  • Activity (muscle tone) 
  • Respiration (breathing) 

These factors help quantify the presence issues such as bradycardia, pallor, lack of or insufficient response to stimulation and apnea. Each component receives a numerical score between zero and two. Every child gets assessed at one minute and five minutes after birth. The higher the score, the less likely the newborn appears to have issues. Infants who score less than seven in the first five minutes may receive the assessment every five minutes up to 20 minutes after birth. 

The Apgar evaluation helps determine a newborn's physiologic condition at a particular moment in time and includes subjective components. Several elements that can affect the score, from how much sedation the mother received to gestational age and trauma. It is a method to record the transition from fetus to infant and not an indicator of brain damage or other injuries. If there is a concern, there are other tests specifically for this purpose. Medical professionals should not use this assessment as a method of predicting an adverse neurologic outcome. Visit our webpage for more information on this topic. 

About the Author

Frank Piscitelli

As a first-generation Italian in the United States, Frank is no stranger to tough times. His father's family moved to Cleveland from Italy on May 22, 1958, with a few articles of clothing, some personal items and very little money. His family shared a home with three other related families but happily worked long hours doing jobs that involved physical labor, just to put food on the table. There was the promise of hope and opportunity, which was missing before his family moved here.


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Attorney Frank Piscitelli has nearly 30 years experience representing individuals and families against large corporations and insurance companies. His practice is limited to wrongful death and very serious injury cases.

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