OB help - GTPAL?

203bravo, MSN, APRN · Oct 27, 2015

This is what I got:
Gravida - 6
Term - 2
Preterm - 3
Abortions - 3 (if losses were before 20 weeks)
Living - 2

Is this right? If not, could someone help me with these? Thank you in advance!!!

For Preterm or Abortions it would be one or the other based on the number of weeks. In your example it would 62302 IF the losses happened at between weeks 20 - 37. OR 62032 IF the losses happened prior to week 20.

Since the example does not give the date of either the live births or the abortions it would be impossible to give an accurate GTPAL.

But you are on the right track. Best of luck.

aeris99 · Oct 27, 2015

Would someone be willing to help me with the OB GTPAL system?

Here is the story:

Mrs. Smith, a 37-year-old Caucasian woman, presented to your OB/GYN office for her first prenatal visit. Mrs. Smith states her last menstrual period began January 15,th and a positive pregnancy test reveals she is pregnant for the sixth time. Her previous pregnancy history includes three spontaneous abortions because of cervical insufficiency/premature dilation of the cervix. Her last two pregnancies were carried to term, but Mrs. Smith had to stay in bed for three months. She also developed gestational diabetes during her last pregnancy. Mrs. Smith is 5 foot 2 inches tall, weighs 190 lbs., and smokes 1 Â½ packs per day.
What is Mrs. Smiths' gravida and para, utilizing the GTPAL system?
This is what I got:
Gravida - 6
Term - 2
Preterm - 3
Abortions - 3 (if losses were before 20 weeks)
Living - 2

Is this right? If not, could someone help me with these? Thank you in advance!!!

It doesn't say at what week she delivered her 2 living children. If they were both over 37 weeks, then term would be 2.

The P is for parity, not preterm. Miscarriages count for parity if they occurred over 20 weeks. If this pregnancy is over 20 weeks, then P=3. P has to be at least 2 because she has 2 living children.

The A is for all aborted pregnancies. This includes miscarriage as well as elective and therapeutic abortion. Gestational age doesn't factor into this one.

My answer, based solely on the case and taking "term" to mean 37+ weeks would be:

G-6

T-2

P-2

A-3

L-2

203bravo, MSN, APRN · Oct 27, 2015

It doesn't say at what week she delivered her 2 living children. If they were both over 37 weeks, then term would be 2.
The P is for parity, not preterm. Miscarriages count for parity if they occurred over 20 weeks. If this pregnancy is over 20 weeks, then P=3. P has to be at least 2 because she has 2 living children.
The A is for all aborted pregnancies. This includes miscarriage as well as elective and therapeutic abortion. Gestational age doesn't factor into this one.
My answer, based solely on the case and taking "term" to mean 37+ weeks would be:
G-6
T-2
P-2
A-3
L-2

I've learned it the same way that here_we_stand has it spelled out:

G - Gravida. This is the number of times a woman has conceived, including any current pregnancy.

T - Term births. This is the number of times a woman has carried a pregnancy to at least 37 weeks gestation and delivered.

P - Preterm births. This is the number of times a woman has delivered before 37 weeks gestation but after 20 weeks gestation.

A - Abortions. This is the number of times a woman has lost a pregnancy, whether it was elective or spontaneous (miscarriage) before 20 weeks gestation.

L - Living children. This term states 'living children' but what it really is referring to is 'live births.'

aeris99 · Oct 27, 2015

In that case I guess OP should go by what the professor and/or textbook she is using says?

I went by my OB book and class notes.

klone, MSN, RN · Oct 28, 2015

It doesn't say at what week she delivered her 2 living children. If they were both over 37 weeks, then term would be 2.
The P is for parity, not preterm. Miscarriages count for parity if they occurred over 20 weeks. If this pregnancy is over 20 weeks, then P=3. P has to be at least 2 because she has 2 living children.2

No, that's not correct. In GTPAL, the P stands for preterm.

And in the OP, she stated that her two children were carried to term. Her verbiage on the three losses were "SAB" so I am assuming it was prior to 20 weeks (typically, we refer to losses after 20 weeks as IUFD or preterm deliveries, not SAB). So it would be G6P2032.

klone, MSN, RN · Oct 28, 2015

L - Living children. This term states 'living children' but what it really is referring to is 'live births.'

No, L literally means living children. If the child died at 2 months or 12 years, they would not be counted in the L.

It also account for multiples. If a woman has only been pregnant once but had triplets at 35 weeks, she would be G1P0103.

babymich_0922 · Oct 28, 2015

Gtpal: Gravida- 6, term- 2, preterm- 0, abortion- 3, living- 2. GPAL is different, where "P" stands for "parity" or "para".

NurseGirl525, ASN, RN · Oct 28, 2015

The P is Preterm, the Para is the sum of everything except the Gravida.

Abortion is before 20 weeks

Preterm is up to 36 weeks

Term is 37-41

Living children is actual living children

The OP is confusing abortion and preterm. A baby cannot be classified as preterm if it is not viable in extrauterine life and fetuses born before 20 weeks are not considered viable in the medical world.