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Table of Contents
Photo by Kei Scampa: https://www.pexels.com/photo/hands-of-a-couple-embracing-the-baby-inside-her-growing-belly-3013668/
Confirmation of Pregnancy and due date: The confirmation of pregnancy and due date is done by ultrasound. This ultrasound is often done between eight to ten weeks and confirms that the fetus has a heartbeat, is located in the uterus, and the size matches how big it is compared to what it should be. If this ultrasound matches the date within five days of what you expect, the EDD stays the same. If it measures outside the five days, the EDD would be changed to the date determined by the ultrasound.
Determining Gravida and Para: Gravida is a term for a woman who is pregnant. Para (or parous) is a term for the number of complete pregnancies a woman has. The following terms are related to this:
Multigravida/Multiparous: A woman who has been pregnant multiple times.
Primigravida/Primiparous: A woman who is pregnant for the first time.
Nulligravida/Nulliparous: A woman who has never been pregnant.
The 5-digit System
The 5-digit System
GTPAL: In obstetrics, the Gravida/Para is documented using the 5-number system: G-TPAL. The first number stands for the number of times a woman has been pregnant; this number will include the current pregnancy. The next four numbers relate to the outcomes of those pregnancies. Aside from when a woman is currently pregnant, the Gravida usually matches the Living. The Term and Preterm usually match the Living. When they do not, consider losses (children that did not survive) or multiples (twins, triplets, etc.). Note that when there is a pregnancy with multiples, the pregnancy is still counted as a single pregnancy (T=1 or P=1), but the living will reflect the number of babies born.
G: Gravida – The number of times a woman has been pregnant.
T: Term – The number of pregnancies that were completed at or after 37 weeks 0 days.
P: Preterm – The number of pregnancies that were completed between 20 weeks and 36 weeks 6 days.
A: Abortions/ Terminations or Miscarriages – Includes spontaneous abortions (SAB), which are also known as miscarriages, ectopic pregnancies, and therapeutic abortions (TAB), which are also known as terminations.
L: Living children - The number of living children.
RegisteredNurseRN.com (2016, December 16). GTPAL Nursing Explanation Made Easy w/ Examples & Practice Problems Quiz | Maternity NCLEX. https://www.youtube.com/watch?v=i7RwqnLhGEE
RegisteredNurseRN.com (2020, January 24). Gravidity and Parity Examples Maternity Nursing NCLEX Review (Gravida & Para). https://www.youtube.com/watch?v=4YlVvP5Z4XM
The 2-digit System
The 2-digit System
G/P: There is also a 2-digit system that has only the G/P. This is used more for people who are done with pregnancy or are seen for a problem that is not related to pregnancy. The Gravida usually matches the Para. When they do not, consider losses (miscarriages, ectopic pregnancies, abortions, or children that did not survive) or multiples (twins, triplets, etc.).
G: Gravida - The number of times a woman has been pregnant.
P: Para – The number of living children
Giorux, M. (2019, January). Antepartum Care: Gravidity & Parity. OBGYNAcademy.https://obgynacademy.com/antenatal-care/
Let's Practice!!
Let's Practice!!
Determine the Gravida and Para for the following women.
During the health history collection on a female patient at a women’s health clinic visit, She the patient tells you she is currently pregnant and has been pregnant three times before. She states that at 39 weeks gestation she gave birth to a boy who is alive and well. However, the other two pregnancies miscarried at 7 and 10 weeks gestation
G4 - T1 P0 A2 L1 ** Remember to count the current pregnancy in the Gravida **
A woman comes to your clinic who is currently pregnant. She says that her first delivery was a son at 39 weeks. She had a healthy girl who was delivered two years later at 38 weeks. Six years later she delivered a baby at 24 weeks that died after 2 hours of life. She had another pregnancy that miscarried at 9 weeks.
G5 - T2 P1 A 1 L2 ** Remember that the child who died is not counted in the Living section **
A woman gave birth to her first child at term, a son and a second child at term, two ectopic pregnancies. and twin girls born prematurely in 2006. She is not currently pregnant.
G5 - T2 P1 A2 L4 ** Remember that the twins count for one pregnancy, but two live children **
Your patient is currently pregnant. She previously had a son born at 36 weeks, a daughter born at 38 weeks, and triplets born at 32 weeks. She also had a miscarriage at 8 weeks gestation before any of her pregnancies.
G 5 - T1 P2 A1 L5 ** Remember that pregnancies before 37 weeks are considered preterm **
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