EXAMPLE: On an OB patient's chart you may see the abbreviations: gravida 3, para 2. This means three pregnancies, two live births. The OB patient, currently pregnant with her third baby, will become a Gravida 3, Para 3 after giving birth. Complications of pregnancyAbruptio placentae- (Latin, "breaking off"). Premature separation of a normally implanted placenta before full term. Occurs in only about 1% of pregnancies. However, it has a 20-40% fetal mortality rate and is a significant contributor to maternal mortality. Placenta previa- (Latin, "leading the way"). A placenta implanted over the cervical region of the uterus blocking the entrance to the birth canal. Occurs in less than one percent of pregnancies, but can cause significant bleeding and require a complicated delivery. Eclampsia (toxemia of pregnancy )- a serious and life-threatening condition that may develop during pregnancy involving hypertension, convulsions and coma. A less severe form, preeclampsia, may develop but can be managed if identified and treated early. Ectopic pregnancy- (Greek, "out of place"). A pregnancy implanted anywhere outside of the uterus. The uterine tube (Fallopian tube) is the most common location, also called a "tubal pregnancy". The abdominal cavity is the least common location. Occurs in about 2% of pregnancies. When it occurs, it is a surgical emergency, because the uterine tube cannot sustain tremendous expansion like the uterus. Eventually, the uterine tube will rupture with severe, possibly fatal, hemorrhaging.
One of the most common questions missed in the EMT and Paramedic OBGYN test involve the terms Gravida and Para. No one wants to hear the paramedic yell over the radio and then to the ER staff that "this chick has been pregant 5 times; she had two kids, two miscarriages and an abortion." So, since these are pertinent factors that need to be communicated in some OB calls, we use G/P/A. Quick version: Gravida means pregnancies and Para means live births. If your patient has had a miscarriage and two live births, you could say she was Gravida 3, Para 2 or simply G3 P2. If the patient has had an abortion, a third notation (A) for Abortus can be used. A more detailed explanation of the rules and finer points courtesy of Wikipedia:
Therefore, the history of a woman who has had two pregnancies (both of which resulted in live births) would be noted as G2P2. The obstetrical history of a woman who has had four pregnancies, one of which was miscarried, would be noted as G4P3A1. That of a woman who has had one pregnancy of twins with successful outcomes would be noted as G1P1 Commentscomments EMTprep Staff Updated Jan 14, 2022
Gravidity and parity are important parts of a complete obstetric history. To put it simply:
For example:
Even though there are multiple fetuses involved, multiple gestation pregnancies (twins, triplets, etc) only count as a single event This information is important for a few reasons:
Nullipara is a patient who has never given birth Primigravida is a patient experiencing their first pregnancy
Primipara is a patient who has given birth once Multigravida is a patient who has been pregnant 2 or more times
Multipara (multiparous) is a patient who has given birth 2 or more times Grand Multigravida is a patient who has been pregnant 5 or more times Grand Multipara is a patient who has given birth 5 or more times
Example 1:
Example 2:
Example 3:
In biology and human medicine, gravidity and parity are the number of times a woman is or has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity).[1] These terms are usually coupled, sometimes with additional terms, to indicate more details of the woman's obstetric history.[2] When using these terms:
In human medicine, "gravidity" refers to the number of times a woman has been pregnant,[1] regardless of whether the pregnancies were interrupted or resulted in a live birth. “Gravidity” is an important component of a patient’s reproductive history, as it provides insight into the risk factors that the patient has for pregnancy outcomes, such as risk for gestational diabetes, pre-ecclampsia, spontaneous abortion, preterm birth, fetal growth restriction, and more.[4] The gravidity of the patient is associated with risk for other conditions as well, including risk for breast, ovarian, and endometrial cancer.[5] Knowing a patient’s obstetric history in a prenatal assessment or early in gestation allows the patient to receive early intervention to prevent these associated risks.[4]
Terms such as "gravida 0", referring to a nulligravida, "gravida 1" for a primigravida, and so on, can also be used. The term "elderly primigravida" has also been used to refer to a woman in their first pregnancy who is at least 35 years old.[6] Advanced maternal age can be a risk factor for some birth defects. In biology, the term "gravid" (Latin: gravidus "burdened, heavy"[7]) is used to describe the condition of an animal (most commonly fish or reptiles) when carrying eggs internally. For example, Astatotilapia burtoni females can transform between reproductive states, one of which is gravid, and the other non-gravid. In entomology it describes a mated female insect. In human medicine, parity is the number of pregnancies carried by a woman for at least 20 weeks (duration varies from region to region, 20 – 28 weeks, depending upon age of viability). If a woman carries the fetus to viable age, even if ultimately the fetus is born deceased, this still counts as an instance of parity, as parity is based on the time of gestation prior to a birth, and not the status of the offspring once born.[8][9] A woman who has never carried a pregnancy beyond 20 weeks is nulliparous and is called a nullipara or para 0.[10] A woman who has given birth once is primiparous and is referred to as a primipara or primip. A woman who has given birth two, three, or four times is multiparous and is called a multip. Grand multipara describes the condition of having given birth five or more times.[11] Like gravidity, parity may also be counted. A woman who has given birth one or more times can also be referred to as para 1, para 2, para 3, and so on. Viable gestational age varies from region to region. NulliparityA nulliparous (/nʌlˈɪpərəs/) woman (a nullipara or para 0) has never given birth. It includes women who have experienced spontaneous miscarriages and induced abortions before the mid-point of pregnancy, but not women who have experienced pregnancy loss after 20 weeks. Nulliparity has been implicated in the development of various complications during pregnancy including preeclampsia, gestational diabetes and pre-term labor.[4] Long-term and permanent nulliparity (/ˌnʌlɪˈpærɪti/) are risk factors for breast cancer. For instance, a meta-analysis of 8 population-based studies in the Nordic countries found that never giving birth was associated with a 30% increase in the risk of breast cancer compared with women who have given birth, and for every 2 births, the risk was reduced by about 16%. Women having their first birth after the age of 35 years had a 40% increased risk compared to those with a first birth before the age of 20 years.[12] In agriculture, parity in biology is a factor in productivity in domestic animals kept for milk production. Animals that have given birth once are described as "primiparous"; those that have given birth more than once are described as "pluriparous".[13][14] Those that have given birth twice may also be described as "secondiparous", in which case "pluriparous" is applied to those that have given birth three times or more. A number of systems are incorporated into a woman's obstetric history to record the number of past pregnancies and pregnancies carried to viable age. These include:
Though similar, GPA should not be confused with the TPAL system, the latter of which may be used to provide information about the number of miscarriages, preterm births, and live births by dropping the "A" from "GPA" and including four separate numbers after the "P", as in G5P3114. This TPAL form indicates five pregnancies, with three term births, one preterm birth, one induced abortion or miscarriage, and four living children.[18] In obstetrics, many types of people can get pregnant and carry a pregnancy, including gender-diverse, non-binary, and intersex persons who have a uterus.[19][20] Gravidity and parity are medical terms that clinicians use to refer to all birthing persons, though medical journals, studies, and general literature often refer to pregnant persons as exclusively “women.”[19] In obstetrics, the term can lead to some ambiguity for events occurring between 20 and 24 weeks,[21] and for multiple pregnancies.[22]
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