Gravidity and Parity (G&Ps, GTPAL)

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Miriam Wahrman
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Study Tools For Gravidity and Parity (G&Ps, GTPAL)

Gravidity and Parity (Cheatsheet)
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Outline

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

FAQ’s

What does gtpal stand for?
GTPAL stands for Gravidity (number of pregnancies including current), Term (number of pregnancies carried to 37+ weeks), Preterm (number of pregnancies carried between 20 and 36.6 weeks), Abortion (number of losses prior to 20 weeks), and Living (number of living children).

Why is gtpal important?
GTPAL is important to understand the woman’s pregnancy history, which will help the providers to be aware of things such as concerns with many losses, if there have been twins, or pregnancies that have been preterm. This will help the providers to better plan care.

What is the meaning of GTPAL in pregnancy?
In pregnancy GTPAL is used to identify the total number of pregnancies, including current pregnancies (Gravidity), the number of pregnancies that have gone to term (Term), the number of pregnancies that have been preterm (Preterm), the number of abortions (Abortion), and the total number living (Living).

How to read gtpal?
GTPAL is read as Gravidity, Term, Preterm, Abortion, and Living. For example, I’m currently 39 weeks pregnant, I have had two children born at 37 and 35 weeks. I lost 3 pregnancies prior to 12 weeks and have 2 living children; this would be read G6 T1 P1 A2 L2.

How do you write gtpal?
The number of pregnancies including current is G (gravidity), pregnancy total carried to term (37 weeks) as T, the preterm (20-36.6 weeks) pregnancy total as P, the abortion total as A (if it after 20 weeks it is counted as preterm), and number of living children is L.

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ADPIE Related Lessons

Related Nursing Process (ADPIE) Lessons for Gravidity and Parity (G&Ps, GTPAL)

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.

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Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Community Health Overview
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Emotions and Motivation
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Labor Complications
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Cardiac Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Shock
  • Infectious Disease Disorders
  • Nervous System
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Epidemiology
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Legal Considerations
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Fundal Height Assessment for Nurses
Injectable Medications
Somatoform
Technology & Informatics
Fall and Injury Prevention
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Overview of the Nursing Process
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Proton Pump Inhibitors
Schizophrenia