A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client’s record?
A.
4-1-2-0-3
B.
3-1-1-0-3
C.
2-1-2-1-2
D.
3-1-2-0-3
The Correct Answer and Explanation is:
The correct answer is D. 3-1-2-0-3.
Explanation:
The GTPAL system is used to summarize a woman’s obstetric history. Each letter in GTPAL represents a different aspect of her pregnancy history:
- G: Gravida – the total number of pregnancies, regardless of outcome or number of fetuses.
- T: Term births – the number of pregnancies that were carried to full term (37 weeks or more).
- P: Preterm births – the number of pregnancies that resulted in preterm birth (from 20 to 36 weeks and 6 days gestation).
- A: Abortions – the number of pregnancies that ended before 20 weeks (spontaneous or elective).
- L: Living children – the number of living children.
Let’s analyze the client’s history based on the given information:
- The client has been pregnant with twins, but this counts as one pregnancy, even though it resulted in two babies being born. These twins were born prematurely, which counts under preterm.
- The client has also delivered one full-term baby, which counts under term.
- The client has no history of abortions.
- She has a total of three living children: the twins and the full-term baby.
Breaking down GTPAL for this client:
- Gravida (G): This is the total number of pregnancies. She has had the pregnancy with the twins, and one full-term pregnancy, so her total number of pregnancies is 3.
- Term (T): She has delivered one full-term baby at or after 37 weeks of gestation.
- Preterm (P): She has delivered premature twins, so this counts as 2 under preterm births.
- Abortions (A): She has had no abortions.
- Living (L): She has three living children (the twins and the full-term baby).
Thus, her GTPAL should be documented as 3-1-2-0-3.
This format provides a concise and complete record of her obstetric history, allowing healthcare providers to understand her previous pregnancies and outcomes efficiently.