PROCESS FIGURE 29.20 Circulatory Changes at Birth

( a ) Circulatory conditions in the fetus.

Apgar test is named for Virginia Apgar, the physician whodeveloped  it. This score evaluates five characteristics of thenewborn: (1) A ppearance, (2) P ulse, (3) G rimace, (4) A ctivity,and (5)  R espiratory effort. Each of these characteristics is ratedon a scale of 0–2, with 2 denoting normal function; 1, reducedfunction; and 0, seriously impaired function. More specificdescriptions of the rankings for each characteristic are shown intable 29.3. For example, a newborn who has a pink complexionat birth is ranked 2 for appearance. The total Apgar score is thesum of the scores from the five characteristics, ranging from

0 to 10. A total Apgar score of 8–10 at 1–5 minutes after birthis considered normal. Other systems that assess neonatal growthand development, including general external appearance andneurological development, also exist.

Congenital Disorders

The term congenital means “present at birth,” and congenitaldisorders are abnormalities commonly referred to as birthdefects. Approximately 70% of all congenital disorders are the

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