Google doodle celebrates American anesthesiologist, Dr Virginia Apgar's 109th birthday, the doctor behind the unique 5-point newborn Apgar score.

Dr Apgar is the woman behind "Apgar score": a unique five-point score given to newborns to assess their health within one to five minutes after birth.

In 1952, Dr. Virginia Apgar devised a new scoring method for assessing the clinical status of a newborn, immediately after birth at 1 minute of age. This was at a time when the focus was more or less on the wellbeing of the woman who had just undergone labor. There lacked a standardized protocol for accurately evaluating the health of a baby after birth resulting in a high infant mortality rate.

Dr. Apgar selected 5 objective signs pertaining to the condition of the infant at birth that could be evaluated and taught to the delivery room personnel without any difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone, and color. Sixty seconds after the complete birth of the baby, a rating of zero, one or two are given to each depending upon whether it was present or absent. The resulting APGAR score ranges from zero to ten. 

The life of Virginia Apgar 

Virginia Apgar was born on June 7, 1909, to Helen and Charles Apgar in Westfield, New Jersey. After graduating from Westfield High, she entered Mount Holyoke College and majored in Zoology. After graduating from Mount Holyoke, she entered Columbia University College of Physicians and Surgeons. Graduating fourth in her class, she received her M.D. degree from Columbia. She was awarded a highly-prized, two-year internship in surgery at Columbia Presbyterian Hospital.

In 1935, after completing her surgical internship, she decided not to practice surgery. Switching careers, she began training at Columbia to become an anesthesiologist.  At 29, she was appointed the head of the division of anesthesiology, under the department of surgery, making her the first female division head in the medical school’s history.

When the division of anesthesiology at Columbia was split off from the department of surgery, Dr. Apgar turned her attention to obstetrical anesthesia. She hit on the idea for a new way to evaluate newborns at birth. While carrying a full clinical load, she attended hundreds of deliveries gathering data to test her idea.

In 1952, she presented the test at a scientific conference and finally in 1953 Dr. Apgar published her newborn scoring system for estimating the viability of a newborn. From then on, the Apgar score disseminated all over the United States. One year later, it found similar resonance in Europe.

The APGAR acronym

As stated  by J. Van Robays in "The story of Virginia Apgar."  (Facts Views Vis Obgyn, 2015, 7 (3): 192-197)

In 1961, Victoria Apgar received a letter from a Dr. Joseph Butterfield, a professor at the Colorado University in Denver. She had already received plenty of praiseful notes after her publication, but the Butterfield letter contained something interesting. One of his residents had come up with the idea of connecting the five letters of APGAR to the five points of attention in a newborn.

Victoria Apgar loved the idea and adopted the acronym immediately. After the introduction of her score, Virginia Apgar continued to do medical research, among other things in the field of acidosis and other acid-base disturbances in newborns.