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Apgar score
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===Interpretation=== [[Image:Apgar score.png|thumb|right|350px|Mind map showing summary for the Apgar score]] Various members of the healthcare team, including midwives, nurses, or physicians, may be involved in the Apgar scoring of a neonate.<ref name=":5"/> The test is generally done at one and five minutes after birth and may be repeated later if the score is and remains low. Scores of seven and above are generally normal; four to six, fairly low; and three and below are generally regarded as critically low and cause for immediate resuscitative efforts.<ref name="Newborn 819β822">{{Cite journal|last1=Newborn|first1=American Academy of Pediatrics Committee on Fetus And|last2=Practice|first2=American College of Obstetricians and Gynecologists Committee on Obstetric|date=2015-10-01|title=The Apgar Score|journal=Pediatrics|language=en|volume=136|issue=4|pages=819β822|doi=10.1542/peds.2015-2651|issn=0031-4005|pmid=26416932|s2cid=31689176|doi-access=free}}</ref> A low score on the one-minute mark may show that the neonate requires medical attention,<ref>{{cite journal | vauthors = Casey BM, McIntire DD, Leveno KJ | title = The continuing value of the Apgar score for the assessment of newborn infants | journal = The New England Journal of Medicine | volume = 344 | issue = 7 | pages = 467β71 | date = February 2001 | pmid = 11172187 | doi = 10.1056/NEJM200102153440701 | doi-access = free }}</ref> but does not necessarily indicate a long-term problem, particularly if the score improves at the five-minute mark. A constellation of factors may contribute to a low Apgar score value.<ref name=":4">{{Cite journal|last=Pediatrics|first=American Academy of|date=2014-05-01|title=Neonatal Encephalopathy and Neurologic Outcome, Second EditionReport of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy|journal=Pediatrics|language=en|volume=133|issue=5|pages=e1482βe1488|doi=10.1542/peds.2014-0724|issn=0031-4005|doi-access=free}}</ref> An Apgar score that remains below three at five minutes and later times, such as 10, 15, or 30 minutes, does not provide supporting evidence for a specific illness but can sometimes be among the first indicators of neonatal encephalopathy.<ref name=":4" /><ref name="Newborn 819β822" /><ref>{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK328263/|title=Care of the baby and woman immediately after birth|date=December 2014|publisher=National Institute for Health and Care Excellence (UK)}}</ref> However, the Apgar test's purpose is to determine quickly whether or not a newborn needs immediate medical care. It is not designed to predict long-term health issues.<ref name="Apgar53">{{cite journal|author-link=Virginia Apgar|vauthors=Apgar V|year=1953|title=A proposal for a new method of evaluation of the newborn infant|url=https://profiles.nlm.nih.gov/ps/access/cpbbkg.pdf|journal=Current Researches in Anesthesia & Analgesia|volume=32|issue=4|pages=260β7|doi=10.1213/00000539-195301000-00041|pmid=13083014}}</ref> A score of 10 is uncommon due to the prevalence of transient [[cyanosis]], and does not substantially differ from a score of nine. Transient cyanosis is common, particularly in babies born at high altitude.<ref>{{cite journal | vauthors = Gonzales GF, Salirrosas A | title = Arterial oxygen saturation in healthy newborns delivered at term in Cerro de Pasco (4340 m) and Lima (150 m) | journal = Reproductive Biology and Endocrinology | volume = 3 | pages = 46 | date = September 2005 | pmid = 16156890 | pmc = 1215518 | doi = 10.1186/1477-7827-3-46 | doi-access = free }}</ref>
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