Many professionals including nurses, doctors, and physicians would speak of woman’s obstetric condition in an acronym. GTPAL is an acronym for G=Gravidity, T=Term birth, P=Preterm birth, A=Abortion or Miscarriage, and L=Living Children. GTPAL provides a complete history of a woman’s obstetrics. Gravidity is defined as the number of times a woman has been pregnant, a ‘term birth’ normally takes 38 or more weeks in childbirth, ‘preterm birth’ takes less than 37 weeks, abortion is the surgical termination of human pregnancy, whereas, the information on the living children of a woman completes the obstetric history.
GTPAL has a role to play in the status of women pregnancies. There are 8 different statuses of women pregnancies, and every nurse shall be aware of their patients’ GTPAL scores. These statuses along with their GTPAL scores have been provided below:
It is a medical term for a women that has no children, never given birth, but had been pregnant once in a lifetime. As mentioned in the NCBI journal, the number of nulliparous women in the United States have been an all-time high in 2014. 47.6% of women in the US with an age between 15 to 44 years do not have children. While considering the GTPAL score for a woman that has been pregnant once in her lifetime and did not resulted in the childbirth is G=1, T=0, P=0, A=1, L=0.
A woman who is pregnant for the first time in her life is termed as primigravida. It is an important event in the life of a woman, but it becomes strictly so to maintain perfect health. Pregnancy induces psychological and biological change in women. Anxiety is a common factor that accompanies pregnant women, while they also cling to the air of sadness and remains frequently tearful. If a woman is in the primigravida phase, then her GTPAL score will be G=1, T=0, P=0, A=0, L=0.
Most often people use the term ‘primigravida’ and ‘primiparous’ interchangebly, but it remains to be technically incorrect. A woman would not be considered primiparous until she has delivered the baby. Therefore, the term can also be defined as a woman who has given birth for the first time on her first pregnancy. Considering a scenario where a woman gives birth on her first pregnancy which led to a ‘term birth’ of 38 weeks, then the GTPAL score will be G=1, T=1, P=0, A=0, L=1. However, if there is a preterm birth then the GTPAL score will be G=1, T=0, P=1, A=0, L=1.
A woman who has been pregnant more than once are referred to as multigravida. According to National Center of Health Statistics, each year more than 1.25 million women in US gives birth to their second child. In another research, multigravida woman’s greatest need is the childcare support and household responsibilities. Considering a scenario where a woman has faced two pregnancies in which one resulted in a preterm childbirth but the other resulted in miscarriage, then the GTPAL score will be G=2, T=0, P=1, A=1, L=1.
A woman who has given birth more than once is referred to as a multiparous woman. A woman who delays pregnancy and childbirth for a later stage of her life due to various reasons such as building up porfessional life and education issues faces complications in pregnancy. Advanced maternal age and chromosomal abnormalities are frequently reported in various research studies. A multiparous woman who has faced 3 pregnancies with two premature childbirths and an abortion have a GTPAL score of G=3, T=0, P=2, A=1, L=2.
The term grand multipara applies to a woman who has delievered infants for 5 or more times. It is not necessary if a baby is liveborn or not, but the minimum requirement of gestation remains at least 24 weeks. These women are generally perceived to be at a higher risk. The term was introduced in 1934, and the reason why the parity starts from 5 is because the threshold of risk increases at this level. If a grand multipara woman has faced 6 pregnancies and all of them resulted in childbirth (2 term birth, 4 preterm birth), then the GTPAL score would be G=6, T=2, P=4, A=0, L=6.
The term grand multigravida is similar to the grand multipara term, but in the former term a woman has been pregnant for five times or more irrespective of the gestational age or childbirth. The particular term is equally dangerous than the above mentioned terminology. If a woman faces 6 pregnancies that resulted in four childbirths (2 term births, 2 preterm births) and 2 abortion then the GTPAL score will be G=6, T=2, P=2, A=2, L=4.
Great Grand Multipara
Great grand multipara is the term which applies for a woman who has delivered seven or more infants beyond the 24 weeks of gestational age. Great grand multipara creates even more complications in pregnancies and giving birth than grand multipara. The reason is because great grand multipara women are much older than grand multipara and does not have physical strength to perform childbirth. If a woman faces 10 pregnancies that results in 8 childbirths (3 term births, 5 preterm births) and 2 miscarriages, then the GTPAL score will be G=10, T=3, P=5, A=2, L=8.