A Question about GTPAL (Pregnancy Codes).

rjflyn, ASN, RN · Mar 15, 2006

Well when I learned it parity ment fetuses carried live to 20 weeks gestation and beyond. Personally i think the whole G P A bla bla bla bla bla just needs to go away, who are we trying to fool anyway. Yeah it works if your trying to put it in some box someplace on a chart. But really isnt it easier and more presice to just say she has been preg 4 times with, 2 live births, an AB at x weeks, a still birth at xx weeks, ect. More relevent and tells you alot more I think.

rj

babyktchr, BSN, RN · Mar 15, 2006

I personally don't see the "T" for term in our language. Graivida para preterm abortion living is what we use. Anything over 20weeks gestation is to be included in the parity portion.

Jolie, BSN · Mar 15, 2006

The (P) means different things, depending on which system you are using.

G ALWAYS means the same thing. It simply means pregnant, so G refers to the total number of pregnancies the patient has had, including the current one.

G1 means first pregnancy; G2 means second pregnancy, etc.

With the GP system, P refers to the number of pregnancies that have progressed to 20 weeks or beyond, regardless of their outcome. A patient who is pregnant for the second time, and has delivered a healthy term baby in her previous pregnancy would be G2P1. Likewise, a patient who is pregnant for the second time, but previously delivered a still born infant at 24 weeks would also be G2P1. A patient who is pregnant for the second time, but miscarried her first pregnancy would be G2P0.

The GTPAL system is more detailed. G still means the same thing: any pregnancy. T refers to any term delivery (any live or still birth after 37 weeks). But P now refers to preterm deliveries. (Deliveries of live or still born infants between 20-37 weeks.) A refers to abortions. By the strictest definition, this refers only to spontaneous abortions (miscarriages before 20 weeks), but most practitioners have expanded it to include spontaneous and therapeutic abortions prior to 20 weeks. And L refers to living children.

So a G4T1P1A1L2, would refer to a pregnant woman who has had 1 term birth, 1 preterm birth, 1 spontaneous or therapeutic abortion, and has 2 living children.

It just takes practice!

DJ Trance AZ, BSN, RN · Mar 15, 2006

Awww!! I get it now!! Thank you SO MUCH for your clarifications!! It has really helped. Now I can understand the example my professor has given in class.

.Eric Tang.

windowxp · Jun 23, 2009

Anyone can explain to me if woman has late abortion after 20 weeks,

how we will cart in GTPAL format?

Elvish, BSN, DNP, RN, NP · Jun 23, 2009

If it is a spontaneous abortion/fetal loss, then it's counted as a Para but not counted as one of the living children. If it's an elective abortion, it's counted (I believe) as a para as well as an abortion....I think. It's so rare that we have elective late-term abortions.

MystyqueOne, BSN, RN · Aug 24, 2010

Hi,

Where would twins be added into the GTPAL? Would it be counted in the Term (if after 37 weeks) and Not the Gravida? So, if a mother was pregnant one time with twins, it would be: G1T2P0A0L2???

Thanks (I realize this is an old thread).

Elvish, BSN, DNP, RN, NP · Aug 24, 2010

If it's a twin birth, assuming the twins are born at term, it would be

G1 T1 P0 A0 L2. If it's triplets, then it's L3, and so on.

All you are counting is pregnancies until you get to the number of living children. So twins/trips/quads+ only count as one pregnancy.

NurseNora, BSN, RN · Aug 28, 2010

TPAL used to be very helpful when trying to figure out a patient's obstetrical history. But now that there are more multiple pregnancies because of ovulation induction and in vitro, things are getting cloudy again.

Sometimes you just have to write it out. Sometimes docs do selective terminations if too many fertalized ova implanted. Despite Octomom, you do have a better chance of carrying 2 or 3 babies and having a good outcome than trying to carry 8. So some women choose to have some terminated. I recently had a patient who had a previous pregnancy of twins, where the first one delivered at 18 weeks and her labor stopped. She carried the second twin to 24 weeks before delivering. That one survived, but another of her children died in a car accident at age 3.

TPAL gives more information than the simple G/P, but you still have to write it out sometimes.

munderwood72 · Feb 24, 2012

I need help with this still, after reading on it. It's confusing when I read my ob book and then look online because of the different answers.

The question that stumps me: an older gravida comes in to clinic and explains her extensive ob history: had two sets of twins each which were born a month before due date, 2 pregnancy losses before 20 weeks and had 5 full term babies. All children born are alive and well.

The two choices that were close to being right:

a) G9 T5 P4 A2 L9

b) G10 T5 P2 A2 L 9

Neither made sense. I think the choices are wrong, I think it is G10 T5 P4 A2 L9

Elvish, BSN, DNP, RN, NP · Feb 24, 2012

munderwood72 said:
I need help with this still, after reading on it. It's confusing when I read my ob book and then look online because of the different answers.
The question that stumps me: an older gravida comes in to clinic and explains her extensive ob history: had two sets of twins each which were born a month before due date, 2 pregnancy losses before 20 weeks and had 5 full term babies. All children born are alive and well.
The two choices that were close to being right:
a) G9 T5 P4 A2 L9
b) G10 T5 P2 A2 L 9
Neither made sense. I think the choices are wrong, I think it is G10 T5 P4 A2 L9

G9 (2 losses, 2 twin pregnancies, 5 term pregnancies = total 9 pregnancies)

T5 (pregnancies carried to term)

P2 (the twin pregnancies -remember you are counting pregnancies, not the number of babies resulting from them)

A2 (losses)

L9