GTPAL
GTPAL is a measurement of the number of pregnancies and deliveries with
different outcomes a patient has had. GTPAL stands for gravidity, term, preterm,
abortion, and living. These words are used to describe a female patients' obstetrical
history. This history helps physicians with pregnancy and how to create quality
treatment plans for specific patients.
GTPAL is very important at the initial assessment to ensure the healthcare
professional has asked for all the crucial information about an individual’s
reproductive history. It also provides a great deal of knowledge of the individual’s
potential complications at a glance, like lost pregnancies or preterm births, and
ensures a better healthcare plan.
G-GRAVIDITY This is the number of times an individual has
conceived, including any current pregnancy.
T-TERM BIRTHS The number of times an individual has carried a
pregnancy to at least 37 weeks of gestation and
delivered.
P-PRETERM (number of pregnancies carried between 20 and 36.6
weeks)
This is important to differentiate that this P is
different from parity. Parity would consist of any
delivery after 20 weeks of gestation, regardless of
whether the child was born alive or stillborn, and any
deliveries after 36 weeks.
A-ABORTION (number of losses prior to 20 weeks),
L-LIVING (number of living children).
GTPAL example calculation
Imagine a patient who has had 2 term deliveries, 1 preterm delivery, 7
miscarriages, and has 2 living children.
• G = 10 (the patient's combined 2 term birth + 1 preterm birth + 7 miscarriages ) •
T = 2 (the patient's 2 term births) • P = 1 (the patient's 1 preterm births) • A = 7
(the patient's 7 miscarriages) • L = 2 (the patient's 2 living children)
Question 1: A 26 year old female is currently 26 weeks pregnant. She had a
miscarriage at 10 weeks gestation five years ago. She has a three year old who was
born at 39 weeks. What is her GTPAL?
Answer: G=3, T=1, P=0, A=1, L=1
Question 2: A 35 year old female is currently pregnant with twins. She has 10 year
old triplets who were born at 32 weeks gestation, and 16 years old who was born at
41 week gestation. Twelve years ago she had a miscarriage at 8 weeks gestation.
Answer: G=4, T=1, P=1, A=1, L=4
ESTIMATING DUE DATES When estimating a patient's due date, there are two
methods you can follow. For both, you will start with the first day of the patient's
last period.
Nagele's rule
Using Nagele's rule, you'll take the first day of the patient's last period, subtract 3
months, then add 1 week, then add one year.
For example: last menstrual period began on September 9, 2010.
Cathy's rule
Cathy's rule is a simplified version of Nagele's rule. You'll take the first day of the
patient's last period, then add 9 months, then add 1 week.
PRIMI-FIRST GRAVIDA-PREGNANCY
Primigravida refers to the first Primipara refers to a woman who has
pregnancy of a woman given birth once
PARA-REFERS TO DELIVERY
MULTI-2 and or More
Multigravida refers to a woman who is Multipara refers to woman who has
now pregnant for the 2nd time or have given birth 2 or more times
been pregnant before
Nulligravida: a woman has never been Nullipara: a woman has never
pregnant. completed a pregnancy at 20 weeks
gestation or greater. A woman who has
never given birth.
Parturient refers to women Puerpera refers to women who
who is in labor. has just given birth.
Menstrual Disorders
Dysmenorrhea refers to painful cramps Menorrhagia is heavy bleeding,
during menstruation. including prolonged menstrual periods
or excessive bleeding during a normal-
length period.
Premenstrual syndrome refers to Metrorrhagia is abnormal bleeding
physical and psychological symptoms between regular menstrual periods.
occurring prior to menstruation.
Amenorrhea is the absence of Oligomenorrhea refers to infrequent
menstruation. menstrual periods.
Hypomenorrhea refers to light periods. Menopause-The time of life when a woman's
ovaries stop producing hormones and
menstrual periods stop. Natural menopause
usually occurs around age 50. A woman is said
to be in menopause when she hasn't had a
period for 12 months in a row.
Menarche is the first menstrual cycle, Polymenorrhea is a term used to
or first menstrual bleeding, in female describe a menstrual cycle that is shorter
humans. than 21 days. A normal menstrual cycle
is between 24 and 38 days long.
Dystocia is defined as abnormal or Eutocia describes normal labor or
difficult labor. childbirth
