Gravidity and parity - recording system

1. Gravidity and parity - recording system 宋碧琳 老師/ 李翰泓 #9301

2. Definition Gravidity the number of time a woman has been pregnant Parity the number of times that she has given birth to a fetus with a gestational age of 20 weeks or more Abortion the total number of induced abortion or miscarriage or ectopic pregnancy before 20 weeks

3. For example ... A women used to give birth to a 30 week dead fetus, and now this mother is pregnant for 12 weeks, what are her gravidity and parity number?

4. Terms - 1 Gravidity nulligravida: a woman who has never been pregnant primigravida: a woman who is pregnant or has been pregnant for one time multigravida or secundogravida: a woman who has been pregnant more than one time

5. Gravidity & Parity- count or not? Molar pregnancy Complete Partial? Ectopic pregnancy Fallopian (tubal) abdominal?

6. Term - 2 Parity nulliparous: a woman who has not given birth previously primiparous: a woman who must have to given birth once multiparous (multip): a woman who has given birth more than 1 times a women who produce more than one within a birth

7. Recording systems GPA system Gravida/Para/Abortus = Gravidity/Parity/Abortion A multiple birth should be interpreted as a single parous event TPAL system T: term births, P: premature births, A: abortions, L: living births GTPAL = Gravidity+TPAL

8. For example... A woman used to miscarriage once, and now has a 2 y/o daughter and a 3 y/o son, now the woman is pregnant again, what’s her GPA number? A woman who has given birth at term once and has had one miscarriage at 12 weeks, what’s her GTPAL number?

9. A woman is pregnant with twins, she gave birth to the first fetus on 26 week, and the other on 37 week, what’s her GP number? If the first fetus delivered by the abovementioned woman died right after labor, what’s her GTPAL number?

10. A woman underwent IVF and got 3 fertilized egg successfully embed. However, one of them miscarriaged at 18 weeks, then the mother gave birth to the rest two at 35 weeks. What’s her GPA and GTPAL number?

11. USMLE A woman presents to your office for prenatal care. She has had two abortions, two second-trimester miscarriages, one ectopic pregnancy, a fetal demise at 37 weeks' gestation, and two live births. Her son, who is now 13 years old, was delivered at 34 weeks' gestation by spontaneous vaginal delivery. Her daughter, who is now 10 years old, was delivered at 38 weeks' gestation by cesarean section secondary to fetal distress during labor. What are her Gs and Ps by simple notation and by TPAL notation, respectively?

12. Conclusion These terms need to be standardized to prevent misinterpretation and misunderstanding These complicated things DO APPEAR IN EXAMS, so please try to clarify them!

13. Reference http://en.wikipedia.org/wiki/Gravidity_and_parity#cite_note-9 http://www.patient.co.uk/doctor/gravidity-and-parity-definitions-and-their-implications-in-risk-assessment http://www.nhs.uk/conditions/Molar-pregnancy/Pages/Introduction.aspx http://www.medscape.com/viewarticle/557082_5 http://www.merriam-webster.com/dictionary/multiparous http://www.usmle-forums.com/usmle-step-2-ck-forum/11328-tpal-system-gravida-para-notation.html