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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Maternal-Newborn Nursing Study Plan

Concepts Covered:

  • Pregnancy Risks
  • Labor Complications
  • Newborn Complications
  • Fetal Development
  • Terminology
  • Prenatal Concepts
  • Newborn Care
  • Labor and Delivery
  • Postpartum Care
  • Postpartum Complications
  • Medication Administration
  • Studying
  • Communication

Study Plan Lessons

Abortion in Nursing: Spontaneous, Induced, and Missed
Abruptio Placentae (Placental abruption)
Acyclovir (Zovirax) Nursing Considerations
Addicted Newborn
Adult Vital Signs (VS)
Alpha-fetoprotein (AFP) Lab Values
Ampicillin (Omnipen) Nursing Considerations
Anemia in Pregnancy
Antepartum Testing
Antepartum Testing Case Study (45 min)
Anti-Infective – Aminoglycosides
Anti-Infective – Lincosamide
Babies by Term
Behind The Red Line – Live Tutoring Archive
Betamethasone and Dexamethasone
Betamethasone and Dexamethasone in Pregnancy
Bicarbonate (HCO3) Lab Values
Blood Cultures
Blood Glucose Monitoring
Blood Transfusions (Administration)
Body System Assessments
Breastfeeding
Butorphanol (Stadol) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Certified Nurse Midwife
Chorioamnionitis
Clindamycin (Cleocin) Nursing Considerations
Congestive Heart Failure (CHF) Labs
Day in the Life of a Labor Nurse
Day in the Life of a Postpartum Nurse
Dexamethasone (Decadron) Nursing Considerations
Direct Bilirubin (Conjugated) Lab Values
Discomforts of Pregnancy
Disseminated Intravascular Coagulation (DIC)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dystocia
Ectopic Pregnancy
Ectopic Pregnancy Case Study (30 min)
Emergent Delivery (OB) (30 min)
Epidural
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythroblastosis Fetalis
Eye Prophylaxis for Newborn
Eye Prophylaxis for Newborn (Erythromycin)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Family Planning & Signs of Pregnancy – Live Tutoring Archive
Fertilization and Implantation
Fetal Alcohol Syndrome (FAS)
Fetal Circulation
Fetal Development
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Environment
Fetal Heart Monitoring (FHM)
Fetal Heart Monitoring Like A Pro – Live Tutoring Archive
Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fundal Height Assessment for Nurses
Furosemide (Lasix) Nursing Considerations
Gestation & Nägele’s Rule: Estimating Due Dates
Gestational Diabetes (GDM)
Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive
Gestational HTN (Hypertension)
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gravidity and Parity (G&Ps, GTPAL)
HELLP Syndrome
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Hemodynamics
Hemoglobin A1c (HbA1C)
Hepatitis B Vaccine for Newborns
Homocysteine (HCY) Lab Values
Hydatidiform Mole (Molar pregnancy)
Hydralazine (Apresoline) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Hyperbilirubinemia (Jaundice)
Hyperemesis Gravidarum
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypovolemic Shock Case Study (OB sim) (60 min)
Incompetent Cervix
Infections in Pregnancy
Initial Care of the Newborn (APGAR)
Inserting a Foley (Urinary Catheter) – Female
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Isotonic Solutions (IV solutions)
Labor Progression Case Study (45 min)
Leopold Maneuvers
Lung Surfactant
Lung Surfactant for Newborns
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate (MgSO4) Nursing Considerations
Magnesium Sulfate in Pregnancy
Mastitis
Maternal Risk Factors
Mechanisms of Labor
Meconium Aspiration
Meds for Postpartum Hemorrhage (PPH)
Meds for PPH (postpartum hemorrhage)
Menstrual Cycle
Methylergonovine (Methergine) Nursing Considerations
Newborn of HIV+ Mother
Newborn Physical Exam
Newborn Reflexes
Nifedipine (Procardia) Nursing Considerations
Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Chorioamnionitis
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Dystocia
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Gestational Diabetes (GDM)
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Incompetent Cervix
Nursing Care Plan (NCP) for Mastitis
Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Newborns
Nursing Care Plan (NCP) for Placenta Previa
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)
Nursing Care Plan (NCP) for Preterm Labor / Premature Labor
Nursing Care Plan (NCP) for Process of Labor
Nursing Care Plan (NCP) for Transient Tachypnea of Newborn
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan for Newborn Reflexes
Nursing Case Study for Maternal Newborn
Nutrition Assessments
Nutrition in Pregnancy
Nutritional Requirements
OB (Labor) Nurse Report to OB (Postpartum) Nurses
OB Course Introduction
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Obstetrical Procedures
Opioid Analgesics in Pregnancy
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Oxytocin (Pitocin) Nursing Considerations
Pediatric Vital Signs (VS)
Physiological Changes
Phytonadione (Vitamin K)
Phytonadione (Vitamin K) for Newborn
Placenta Previa
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Discomforts
Postpartum Hematoma
Postpartum Hemorrhage (PPH)
Postpartum Interventions
Postpartum Physiological Maternal Changes
Postpartum Thrombophlebitis
Precipitous Labor
Preeclampsia (45 min)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Preload and Afterload
Premature Rupture of the Membranes (PROM)
Preterm Labor
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Process of Labor
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Process of Labor – Live Tutoring Archive
Process of Labor 2 – Live Tutoring Archive
Prolapsed Umbilical Cord
Promethazine (Phenergan) Nursing Considerations
Prostaglandins
Prostaglandins in Pregnancy
Protein (PROT) Lab Values
Retinopathy of Prematurity (ROP)
Rh Immune Globulin (Rhogam)
Rh Immune Globulin in Pregnancy
Signs of Pregnancy – Live Tutoring Archive
Signs of Pregnancy (Presumptive, Probable, Positive)
Spironolactone (Aldactone) Nursing Considerations
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Subinvolution
Terbutaline (Brethine) Nursing Considerations
Tips & Advice for Newborns (Neonatal IV Insertion)
Tocolytics
Tocolytics
Top 5 Misunderstood OB Concepts – Live Tutoring Archive
Transient Tachypnea of Newborn
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Uterine Stimulants (Oxytocin, Pitocin)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
What the Heck is Antepartum Testing? – Live Tutoring Archive