A wry view of life for the world-weary

A Measure Of Things – Part Two


The Apgar scale

The arrival of a little one is a source of immense pride and joy to the parents and, of course, the doting grandparents, the world over. After the initial joy of the sprog popping out the immediate question – these days the identity of its sex is generally known prepartum – is whether it is OK. Ignoramus that I am, it came as a bit of a surprise to me that there is a method for evaluating the newborn child which for the experienced midwife takes a matter of seconds to use.

The Apgar scale, for that is what it is called, was the brain child of Virginia Apgar, an anaesthetist who developed it as a quick way of assessing the effect of obstetric anaesthesia on babies. She published her paper in the ever-popular Current Researches in Anaesthesia and Analgesia that year and it has been adopted since then. Without knowing it, I probably had a score when I popped out of my mother’s womb, although quite what it was I don’t know.

The scale used five criteria for assessing the sprog normally within the first five minutes of its birth-  skin colour, pulse rate, reflex grimace and irritability, activity and respiratory effort – and awarded a score between 0 and 2 in each category. The child, therefore, could have a maximum score of 10 and a minimum of 0 but most would be somewhere in between.

A child would score 0 in skin colour if it was blue all over, a 1 if there was blueness at the extremities and a 2 if the body and extremities exhibited a normal complexion. The absence of a pulse rate would score a 0 while a rate in excess of 100 beats per minute would attract a 2, a 1 being reserved for a rate in between. If there was no reaction from the baby when it was prodded, it would be marked down with a zero whereas a cry on stimulation would earn it a score of 2. A silent grimace would score a one. If the child showed no obvious signs of movement it would score a zero, some flexion of the limbs would attract a one and flexed arms and legs which resisted extension would score top marks. Finally, a baby with a strong, robust cry would attract a two but one with weak, irregular breathing would score a one and when where breathing seemed absent would attract a zero.

Now I’m no expert but a consistent score of zero across each of the categories doesn’t sound good. Indeed, a score of 3 or below is regarded as critically low and tests would be repeated to check on progress. On the other hand, scores of 7 or over are considered normal and those in the middle are fairly low. The objective behind the scale is not to be predictive of long-term health but to get a sense of how quickly it needs attention. Hats off to Virginia.

If you consider the criteria used carefully and apply synonyms – skin colour = Appearance, pulse rate = Pulse, reflex etc = Grimace, Activity and respiratory effort = Respiration – you will note that you have Virginia’s surname. I often wonder if there really is something in nominative determinism, where some people’s futures are predicted for them by their surnames. After all, we have a Lord Justice Judge, I know of a Canon Parsons and Lou Gehrig was thought to have suffered from Gehrig’s disease, although it later transpired that he didn’t. Be that as it may, what we have here is an example of a backronym, the retro-fitting of a mnemonic to an existing word or acronym.

If you are anticipating a happy event, why not ask for the Apgar score. It will guarantee you extra kudos in the delivery room.


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