02.02 Gravidity and Parity (G&Ps, GTPAL)

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Overview

  1. Definitions
    1. Gravida = pregnant woman
    2. Gravidity = number of pregnancies
    3. Parity = the number of births carried to a viability (at least 20 weeks)
      1. Whether or not the fetus was born alive
    4. Nullipara = never given birth
      1. Includes miscarriage or abortion prior to 20 weeks
  2. G/P
    1. Used in clinical setting to record the gravidity and parity
    2. Often written ie: G2/P1
      1. Someone in second pregnancy with 1 successful birth previously

Nursing Points

General

  1. Use of GTPAL acronym
    1. More detailed breakdown of  parity
    2. G-Gravidity = Number of pregnancies, including any current pregnancies (regardless of current gestational age)
    3. T-Term births = Number of pregnancies carried to 37+ weeks
    4. P-Preterm births = Number of births between 20-37 weeks
    5. A-Abortions/Miscarriages = number of pregnancies which ended in miscarriage or abortion. Include in parity if past 20 weeks.
    6. L-Living children = the number of living children (this is where multiples count individually)

Assessment

  1. Gather the patient’s pregnancy history and note gestation of current pregnancies
  2. Examples
    1. A woman with a history of 5 pregnancies: 2 births at 39 and 40 weeks, and 3 miscarriages before 20 weeks
      1. G5 T2 P0 A3 L2
      2. *note – error in the video, if this patient is ALSO currently pregnant, she would actually be a G6 T2 P0 A3 L2
    2. A woman currently pregnant with a history of 1 miscarriage (22 weeks)
      1. G2 T0 P1 A0 L0
    3. A woman with twins born at 32 weeks, history of 2 miscarriages (11 and 9 weeks), and currently pregnant
      1. G4 T0 P1 A2 L2

Therapeutic Management

  1. Knowing GTPAL helps the OB team to know whether the mother is at high risk for complications, whether it is her first birth, etc.
  2. This helps to tailor interventions and management specific for each patient  based on their needs.

Nursing Concepts

  1. Reproduction
  2. Human development

Reference Links

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Video Transcript

In this lesson we are going to talk about gravidity and parity. This is also known as the “Gs and Ps”. Gravidity is recorded as G’s in the clinical setting and will include the current pregnancy. If you remember Gravidity means the number of pregnancies. For example if you have a patient that has never had a child and is her first pregnancy She is a G1 or if she is in her second pregnancy she is a G2. So it is the total number of pregnancies NOT deliveries. Parity refers to the “Ps”. This is their number of pregnancies that have gone past 20 weeks gestation. So for an example a patient is in her third pregnancy and has had 1 child deliver at 38 weeks. She is a G3P1. When she delivers the current pregnancy she will be a G3P2. So somewhere in the equation she had a loss before 20 weeks.

What is all the talk about GTPAL? It stands for Gravidity, Term, Preterm, Abortions, and Living children. This is just a more detailed breakdown of parity. I will explain it to make it easier because you will be tested on this. So again gravidity is the total number of pregnancies no matter what the gestational age is. T is term and this is pregnancies carried to 37 or more weeks. P is preterm and this is pregnancies that are 20-37 weeks. A is abortions which is spontaneous abortions also known as miscarriage or therapeutic abortions. If this is after 20 weeks it is included in the parity. And L is living children. This is where we count each individual child. So if there had been a pregnancy of twins that would be a G1 because its one pregnancy and then each child is counted individually, so it would be L2.

For assessment we need to gather the patient’s history. This is her medical history but also her pregnancy history. So how many pregnancies has she had? How far along is this current pregnancy? We need to know this to properly care for the patient and to properly document her GTPAL. If you have a patient who has a history of 5 pregnancies : 2 births at 39 and 40 weeks, and 3 miscarriages before 20 weeks what is the GTPAL? So this would be a G5 T2 P0 A3 L2. She has had 5 pregnancies, 2 at term, 0 preterm, 3 miscarriages which is A and 2 living children.

So why is GTPAL so important to know? We need to know what the mother’s pregnancy history is so that we will have a better understanding of any high risk complications she has had with pregnancies in the past so we can try to provide safe care and interventions. If a mom has had multiple preterm deliveries we need to know so we can try to care for her better to hopefully prevent this from occurring again. If a mom has had multiple miscarriages we need to know so if we can prevent with interventions then we can do that.

Let’s practice writing out GTPAL with some scenarios. Your patient is pregnant for the first time, no babies. She is a G1P0. Now she has the baby at 37 weeks and she is a G1P1. Then she gets pregnant again. She is a G2P1. She has a miscarriage at 9 weeks. She is a G2P1. In terms of GTPAL, she would be a G2, T1, P0, A1, L1. Now the patient gets pregnant with twins. She is a G3P1. The twins are born at 38 weeks so now she is a G3, T2, P0, A1,L3. Hopefully seeing it in this way helps explain better!

Gravidity and Parity deal with human development and reproduction so these are nursing concept
Some key points that we need ro review and commit to memory or the terms Gravida, Gravidity, Parity, and Nullipara. Gravida just means pregnant woman. Gravidity refers to the number of pregnancies and remember this includes the current pregnancy. Parity is the number of births carried to a viability. And what is viability?( At least 20 weeks! This Whether or not the fetus was born alive. Nullipara means never gave birth. You can remember this by the letter N. Nullipara =never. Nullipara will include those that have never had a baby but have been pregnant but had as miscarriage or abortion prior to 20 weeks

Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.

Read more

  • Question 1 of 5

A nurse is gathering medical history for a client who has just arrived on the Labor and Delivery unit. She is currently pregnant with twins and says she has had 1 miscarriage at 6 weeks and has a healthy girl at home that was 37 weeks when born. What GTPAL should be documented by the nurse?

  • Question 2 of 5

A student nurse is explaining gravidity to a client. Which explanation by the student demonstrates proper understanding?

  • Question 3 of 5

A nurse is caring for a client in an OB/Gyn clinic. The client expresses she is not comfortable explaining her pregnancy history to the Provider, because she is embarrassed to share she had a miscarriage. What is the most appropriate response?

  • Question 4 of 5

A nurse is gathering a medical history for a client who has just arrived on the Labor and Delivery unit. The client has twins born at 32 weeks, history of 2 miscarriages (11 and 9 weeks), and is currently pregnant. What GTPAL should be documented by the nurse?

  • Question 5 of 5

A nurse is gathering a medical history for a client who has just arrived on the Labor and Delivery unit. The client is currently pregnant with a history of 1 miscarriage at 22 weeks. What GTPAL should be documented by the nurse?

Module 0 – OB Course Introduction

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