Google celebrates the 109th birth anniversary of Dr. Virginia Apgar

Did you look at today's Google Doodle as you went to search something on the internet?  Google celebrates the 109^th birth anniversary of Dr. Virginia Apgar by creating a special doodle in her honor today.

Virginia Apgar was an American Anesthesiologist, widely known for her groundbreaking invention of Apgar neonatal scoring system that has saved countless newborn lives around the world.

Dr. Apgar was born on 7 June 1909 in New Jersey, United States and completed her medical school at Columbia University College of Physicians and Surgeons. She did her surgical residency in 1937 and then invested a year to train in the field of anesthesia.

She had to face several obstacles in finding work, until 1940, when anesthesia was recognized as a separate specialty. Later she also received training in obstetric anesthesia which aspired her to create the Apgar score.

While working in New York, she was deeply troubled by the ways babies were handled after birth. There was no fixed standard of neonatal care and babies who were blue at birth were recorded as stillborn and no attempts were made to resuscitate them.

Appalled by the lack of care, she designed a scoring system in 1952 which evaluates the newborns' health on five factors: heart rate, respiration, skin color, muscle tone, and reflexes. It soon became evident that even babies with a low Apgar rating at birth could be revived to a good score at 5 minutes by giving Oxygen and maintain the warmth.

Soon, the Apgar score was adopted by the hospitals in the US and is credited with lowering the Infant Mortality Rate.

Rachel Swaby, the author of "Headstrong: 52 Women who Changed Science-and the World," included Virginia Apgar in her list and told CNN in 2015, "It [the Apgar Score] was a huge public health breakthrough. Virginia Apgar had such amazing energy and such an energetic mind."

Today, Apgar score is recognized as standardized assessment for infants after delivery worldwide. The score is reported at 1 minute and 5 minutes after birth for all infants, and at 5-minute intervals thereafter until 20 minutes for infants with a score less than 7.

It reports the condition of the newborn at birth and its response to the neonatal resuscitation attempts; however, it has been inappropriately used to predict an individual adverse neurologic outcome.

It does provide a guidance whether continues resuscitative efforts are indicated or not in a newborn with an Apgar score that remains 0 beyond 10 minutes of age because very few infants with a score of 0 at the end of 10 minutes have survived with a normal neurological performance.

Apgar score has its limitations because it is a snapshot of the physiological condition of the newborn at one point in time and also includes subjective components. It can be affected by gestational age, maternal sedation or anesthesia, congenital malformations and interobserver variability.

When properly applied gives us a standardized assessment of newborn at birth and its response to resuscitation efforts. It does diagnose asphyxia nor it predicts individual neonatal mortality, neurological outcome.  

Virginia Apgar went to medical schools in early 1900 when medical schools seldom accepted female students. Undaunted, Virginia continued her journey in the field of Medicine and became the first full-time woman professor at Columbia in 1949.

She was awarded three privileged doctorates and earned a degree in public health from John’s Hopkins. She has several publications and articles to her name, including a book “Is My Baby All Right”?

She dies in 1974 due to cirrhosis of the liver and was posthumously inducted into the National Women's Hall of Fame in 1955.

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