Department of History of Medicine

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Penza State University
Medical Institute
Department of History of Medicine
Course Paper In
( Virginia Apgar [19091-1974] )
(Anesthesiologist Who Devised The Apgar Score Used After Childbirth )
Name : Seyam Mahmoud Ahmedٍ
.
Group : 19lC2a.
Year : First Year.
Doctor : Gavrilova Tatiana.
Penza 2020

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Contents:
1 How is Virginia apgar . (3)
2 Early life and education. (3)
3- Work and research. (4)
4 Honors and awards. (8)
4 Death. (9)
4 Reference. (10)
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How is Virginia Apgar .
"Nobody, but nobody, is going to stop breathing on me!"
Virginia Apgar (June 7, 1909 – August 7, 1974) was an American obstetrical
anesthesiologist, best known as the inventor of the Apgar Score, a way to quickly
assess the health of a newborn child immediately after birth in order to combat
infant mortality. She was a leader in the fields of
anesthesiology and teratology, and introduced obstetrical considerations to the
established field of neonatology.
Early life and education.
The youngest of three children, Apgar was born and raised in Westfield, New
Jersey, the daughter of Helen May (Clarke) and Charles Emory Apgar. Her father
was a business executive and amateur astronomer whose amateur radio work
exposed an enspionage ring during World War I. Her older brother died early from
tuberculosis, and her other brother had a chronic illness. She graduated from
Westfield High School in 1925, knowing that she wanted to be a doctor.
Apgar graduated from Mount Holyoke College in 1929, where she studied
zoology with minors in physiology and chemistry.In 1933, she graduated fourth in
her class from Columbia University College of Physicians and Surgeons (P&S)
and completed a residency in surgery at P&S in 1937.
She was discouraged by Allen Whipple, the chairman of surgery at ColumbiaPresbyterian Medical Center, from continuing her career as a surgeon because he
had seen many women attempt to be successful surgeons and ultimately fail. He
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instead encouraged her to practice anesthesiology because he felt that
advancements in anesthesia were needed to further advance surgery and felt that
she had the "energy and ability" to make a significant contribution. Deciding to
continue her career in anesthesiology, she trained for six months under Ralph
Waters at the University of Wisconsin–Madison, where he had established the first
anesthesiology department in the United States. In a 1937 photograph of Waters
and his residents, she is the only woman among Waters and fifteen other men. She
then studied for a further six months under Ernest Rovenstine in New York at
Bellevue Hospital. She received a certification as an anesthesiologist in 1937,and
returned to P&S in 1938 as director of the newly formed division of
anesthesia.She later received a master's degree in public health at Johns Hopkins
School of Hygiene and Public Health, graduating in 1959.
Work and research:
Apgar was the first woman to head a specialty division at Columbia-Presbyterian
Medical Center (now NewYork–Presbyterian Hospital) and Columbia University
College of Physicians and Surgeons. In conjunction with Allen Whipple, she
started P&S's anesthesia division. She was placed in charge of the division's
administrative duties and was also tasked with co-ordinating the staffing of the
division and its work throughout the hospital. Throughout much of the 1940s, she
was an administrator, teacher, recruiter, coordinator and practicing physician.[5]
Dr. Virginia Apgar, standing, facing right, examining baby with stethoscope.
Virginia Apgar examining a newborn baby in 1966It was often difficult to find
residents for the program, as anesthesiology had only recently been converted
from a nursing specialty to a physician specialty. New anesthesiologists also faced
scrutiny from other physicians, specifically surgeons, who were not used to having
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an anesthesia-specialized MD in the operating room. These difficulties led to
issues in gaining funding and support for the division. With America's entrance
into World War II in 1941, many medical professionals enlisted in the military to
help the war effort, which created a serious staffing problem for domestic
hospitals, Apgar's division included.
When the war ended in 1945, interest in anesthesiology was renewed in returning
physicians, and the staffing problem for Apgar's division was quickly resolved.
The specialty's growing popularity and Apgar's development of its residency
program prompted P&S to establish it as an official department in 1949. Due to
her lack of research, Apgar was not made the head of the department as was
expected and the job was given to her colleague, Emmanuel Papper. Apgar was
given a faculty position at P&S.
In 1949, Apgar became the first woman to become a full professor at P&S, where
she remained until 1959. During this time, she also did clinical and research work
at the affiliated Sloane Hospital for Women, still a division of NewYork –
Presbyterian Hospital. In 1953, she introduced the first test, called the Apgar
score, to assess the health of newborn babies.
Between the 1930s and the 1950s, the United States infant mortality rate
decreased, but the number of infant deaths within the first 24 hours after birth
remained constant. Apgar noticed this trend and began to investigate methods for
decreasing the infant mortality rate specifically within the first 24 hours of the
infant's life. As an obstetric anesthesiologist, Apgar was able to document trends
that could distinguish healthy infants from infants in trouble.
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his investigation led to a standardized scoring system used to assess a newborn's
health after birth, with the result referred to as the newborn's "Apgar score". Each
newborn is given a score of 0, 1 or 2 (a score of 2 meaning the newborn is in
optimal condition, 0 being in distress) in each of the following categories: heart
rate, respiration, color, muscle tone and reflex irritability. Compiled scores for
each newborn can range between 0 and 10, with 10 being the best possible
condition for a newborn. The scores were to be given to a newborn one minute
after birth, and additional scores could be given in five-minute increments to guide
treatment if the newborn's condition did not sufficiently improve. By the 1960s,
many hospitals in the United States were using the Apgar score consistently. In the
21st century, the score continues to be used to provide an accepted and convenient
method for reporting the status of the newborn infant immediately after birth .
In 1959, Apgar left Columbia and earned a Master of Public Health degree from
the Johns Hopkins School of Hygiene and Public Health. From 1959 until her
death in 1974, Apgar worked for the March of Dimes Foundation, serving as vice
president for medical affairs and directing its research program to prevent and
treat birth defects.
As gestational age is directly related to an infant's Apgar Score, Apgar was one of
the first at the March of Dimes to bring attention to the problem of premature
birth, now one of the March of Dimes' top priorities. During this time, she wrote
and lectured extensively, writing articles in popular magazines as well as research
work. In 1967, Apgar became vice president and director of basic research at The
National Foundation-March of Dimes.
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During the rubella pandemic of 1964–65, Apgar became an advocate for universal
vaccination to prevent mother-to-child transmission of rubella. Rubella can cause
serious congenital disorders if a woman becomes infected while pregnant.
Between 1964 and 1965, the United States had an estimated 12.5 million rubella
cases, which led to 11,000 miscarriages or therapeutic abortions and 20,000 cases
of congenital rubella syndrome. These led to 2,100 deaths in infancy, 12,000 cases
of deafness, 3,580 cases of blindness due to cataracts and/or microphthalmia and
1,800 cases of intellectual disability. In New York City alone, congenital rubella
affected 1% of all babies born at that time.
Apgar also promoted effective use of Rh testing, which can identify women who
are at risk for transmission of maternal antibodies across the placenta where they
may subsequently bind with and destroy fetal red blood cells, resulting in fetal
hydrops or even miscarriage.
Apgar traveled thousands of miles each year to speak to widely varied audiences
about the importance of early detection of birth defects and the need for more
research in this area. She proved an excellent ambassador for the National
Foundation, and the annual income of that organization more than doubled during
her tenure there. She also served the National Foundation as Director of Basic
Medical Research (1967–1968) and Vice-President for Medical Affairs (1971–
1974). Her concerns for the welfare of children and families were combined with
her talent for teaching in the 1972 book Is My Baby All Right?, written with Joan
Beck.
Apgar was also a lecturer (1965–1971) and then clinical professor (1971–1974) of
pediatrics at Cornell University School of Medicine, where she taught teratology
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(the study of birth defects). She was the first to hold a faculty position in this new
area of pediatrics. In 1973, she was appointed a lecturer in medical genetics at the
Johns Hopkins School of Public Health.
Apgar published over sixty scientific articles and numerous shorter essays for
newspapers and magazines during her career, along with her book, Is My Baby
All Right?. She received many awards, including honorary doctorates from the
Woman's Medical College of Pennsylvania (1964) and Mount Holyoke College
(1965), the Elizabeth Blackwell Award from the American Medical Women's
Association (1966), the Distinguished Service Award from the American Society
of Anesthesiologists (1966), the Alumni Gold Medal for Distinguished
Achievement from Columbia University College of Physicians and Surgeons
(1973) and the Ralph M. Waters Award from the American Society of
Anesthesiologists (1973). In 1973 she was also elected Woman of the Year in
Science by the Ladies Home Journal.
Apgar was equally at home speaking to teens as she was to the movers and
shakers of society. She spoke at March of Dimes Youth Conferences about teen
pregnancy and congenital disorders at a time when these topics were considered
taboo.
Honors and awards:
Honorary doctorate, Women's Medical College of Pennsylvania (1964)
Honorary doctorate, Mount Holyoke College (1965)
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Distinguished Service Award from the American Society of
Anesthesiologists (1966)
Elizabeth Blackwell Award, from the American Women's Medical
Association (1966)
Honorary doctorate, New Jersey College of Medicine and Dentistry (1967)
Alumni Gold Medal for Distinguished Achievement, Columbia University
College of Physicians and Surgeons (1973)
Ralph M. Waters Award, American Society of Anesthesiologists (1973)
Woman of the Year in Science, Ladies Home Journal (1973)
Fellow of the New York Academy of Medicine, the American Public Health
Association, and the New York Academy of Sciences.
Death:
Apgar never married or had children, and died of cirrhosis[15] on August 7, 1974,
at Columbia-Presbyterian Medical Center. She is buried at Fairview Cemetery in
Westfield.
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Reference:
1 https://en.wikipedia.org/wiki/Virginia_Apgar
2 https://cfmedicine.nlm.nih.gov/physicians/biography_12.html
3 https://journals.lww.com/anesthesiaanalgesia/Fulltext/2015/05000/Dr
Virginia_Apgar_and_the_Apgar_Score__ How_the.23.aspx
4 https://www.marchofdimes.org/news/march-of-dimes-honors-100thanniversary-of-virginia-apgar.aspx
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6 https://profiles.nlm.nih.gov/spotlight/cp/feature/biographical
7 https://en.wikipedia.org/wiki/Women_in_World_History
8 https://pubmed.ncbi.nlm.nih.gov/11242930/
9 http://c250.columbia.edu/c250_celebrates/remarkable_columbians/virginia_a
pgar.html
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