GPTPAL Question

ThatTallNurse, ADN, RN · Oct 11, 2019

I believe this would make her a G4 P4 T2 P2 A0 L4, because she is in her fourth gestation, with 4 children (a "parity" of 4), 2 delivered at term and 2 delivered preterm (the twins each count as a delivery. If it helps you to remember, think like this... one twin can be delivered early and we can "keep mom pregnant" to deliver one twin at term or at least later in some situations). No abortions, and 4 living children.

Ohm108, MSN, NP, CNM · Oct 11, 2019

Parity reflects the number of live births after 20 weeks, not the total number of individual babies born. We also don’t normally combine the two methodologies.

Either you use G and Ps

or

You use GTPAL

In your scenario, it would be G4P3 because this is the patient’s fourth pregnancy and she had 3 live births previously. The two term births at 38 weeks which I assume were at two different times even though they are the same gestational age at birth since it wasn’t stated that they were another twin birth and the twin preterm birth at 36 weeks which counts as one birth. She will only be a G4P4, after she delivers her current baby.

Since she is in her 2nd trimester which puts her at 24 weeks, we already know that the current gestating baby will either be a T or P in GTPAL depending upon the week the baby is born.

In GTPAL, it would be G4 T2 P1 A0 L4. So what you have is correct minus the parity since we would already know that by adding the T and the P together. Remember that with T and P, we only count the number of births not the number of babies born. So any multiple birth counts only as 1 regardless of the actually number of babies for T and P. The L can be confusing because the sum of T and P don’t match the L because it can either because she had multiples OR because the patient has an adopted kid OR there could be children from a previous marriage with her spouse. The L does not differentiate between these things and it can also be dependent on what the person who is entering the data decides to put in for the L or how in-depth they went into the patient medical and social history.

CaneRN · Oct 11, 2019

Thank you for your comments. So just to clarify, to list the G and G followed by TPAL is redundant or unnecessary? As I listed before I had G4P3T2P1A0L4, but the para is wrong to list or at least not the way I have it? Thank you!

klone, MSN, RN · Oct 12, 2019

20 hours ago, CaneRN said:
Q: A Pt in her second trimester comes in for a prenatal visit. This is her 4th pregnancy. She currently has 2 living children delivered at 38 weeks and one set of twins delivered at 36 weeks.
This is my assessment: G4 P3 T2 P1 A0 L4

Your assessment is correct

Ohm108, MSN, NP, CNM · Oct 13, 2019

On 10/11/2019 at 11:22 AM, CaneRN said:
Thank you for your comments. So just to clarify, to list the G and G followed by TPAL is redundant or unnecessary? As I listed before I had G4P3T2P1A0L4, but the para is wrong to list or at least not the way I have it? Thank you!

It is redundant and also confusing since you already have a P for Preterm but then you have another P for Parity. Normally, we take out the parity if you are using GTPAL since as I said before you will know parity by adding up the term births with the preterm births. But if your hospital does lists both parity and preterm go by their guidelines or if this is how your preceptor/instructor is teaching you, then follow their instructions.