Who Was Dr. Apgar of the Apgar Score?

Medical professionals make sweeping assessments when they work. Doctors, nurses, and midwives (among others) are trained to pick up details that give them clues on what is going on. One such assessment is the Apgar score, which is done on every newborn and has been done for almost 60 years now.

What is the Apgar score? The Apgar score, named after Dr. Virginia Apgar, looks at how the newborn is 1 minute after birth and again at 5 minutes after birth. They are looking at how the baby moves and muscle tone (Activity), heart rate (Pulse), reflex (Grimace response), skin color (Appearance), and breathing rate and effort (Respiration).

Each assessment is worth from 0 to 2 points. If the assessment is good, the baby gets 2 points, if it’s absent, the baby gets zero, if it’s there but could be better, the baby gets 1. The total score is out of 10.

But who is Virginia Apgar and what brought her to come up with the scoring system?

Born in 1909, Dr. Apgar went to school to become a doctor and ended up specializing in pediatric anesthesiology. She began working for the March of Dimes in 1959 and continued to work for them until she died in 1974.

Because the Apgar score varies heavily depending on when the baby was born, Dr. Apgar understood that preventing premature deliveries was an important part in reducing birth defects and the need for good neonatal care for babies born too early.

Rubella

In her work to help prevent birth defects, Dr. Apgar was one of the doctors who pressed hard for universal vaccination of German measles (rubella ) so that pregnant women wouldn’t contract it. When a pregnant woman develops German measles, particularly during the first 5 months of her pregnancy, her baby can develop several complications, including damage to the heart.

Rh Testing

Dr. Apgar was also involved in potentially saving millions of lives through her promotion of Rh testing for pregnant women. Although there are only four blood types, A, B, AB, and O, you can be either negative or positive (i.e., O positive, AB negative). That positive or negative refers to protein. If you have that protein, you’re positive, if you don’t, you’re negative.

A woman who is Rh negative can have a baby who is Rh positive if the father is Rh positive. While this isn’t usually a problem during a first pregnancy, it can set off a chain of events that will cause problems in later pregnancies.

If an Rh negative mother delivers an Rh positive baby, during delivery, the blood between baby and mother mixes and the protein enters the mother’s blood system. Her body then makes antibodies against this foreign protein. If she becomes pregnant again with another Rh positive baby, her body sees it as something foreign and must be destroyed, resulting in miscarriages or an illness in the baby called hemolytic disease, which is very serious. However, if the mother has developed antibodies after delivering an Rh positive baby, this wouldn’t affect future pregnancies if the babies are Rh negative. Women who are Rh positive need not worry about any of this.

There are treatments to prevent the transfer of the protein from an Rh positive baby to an Rh negative mother. Women who are Rh negative who have become pregnant by men who are Rh positive can receive Rh immoglobulin , which acts like a vaccine. They get this vaccine around the 28th week of pregnancy. Then, after the baby is born, if he or she is Rh positive, the mother will get a second dose. Dr. Apgar pushed Rh testing as she had realized the effectiveness of such programs.

And More

Dr. Apgar advocated for birth defects registries and for making genetic history and pregnancy history a routine part of medical record keeping for pregnant women. She pushed for issues that would affect pregnant women and their babies and her work still affects us all today.

I think we all should know a bit more about Dr. Apgar and her contributions – she deserves it.

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Images: Stock.xchnge, iStock.com