Maternity Nursing 101 includes GTPAL. It is used on every single pregnant patient to assess the outcomes. As a nursing student or a nursing graduate taking the NCLEX, it is essential to be able to read the pregnant patient’s history and calculate the GTPAL.
BREAKDOWN OF GTPAL:
Gravida – Number of times the woman has been pregnant
Term – Number of times a baby has been born 37 weeks gestation
Preterm – Number of times a baby has been born 20-37 weeks
Abortion – Pregnancy losses before 20 weeks
Living children – Number of children that are living
WHAT YOU NEED TO KNOW ABOUT GTPAL FOR THE NCLEX:
Gravidity includes current pregnancy, miscarriages, abortion.
Twins, triplets, etc. count as one in every category except living children. They would count individually.
Stillborn still count towards term births and preterm births. If a mother had two children born after 37 weeks but one was a stillborn, it’d still count as 2 terms.
If a mother had three children born at 35 weeks with one stillborn, it’d still count as 3 preterm births.
If an infant died after 20 weeks, it’d be considered pre-term/term and not be considered as an abortion.
GTPAL POP QUIZ TIME
GTPAL SCENARIO #1
31 years old patient is currently 28 weeks pregnant with a miscarriage at 9 weeks gestation 2 years ago. She currently has a four years old child who was born at 38 weeks. What is her GTPAL?
Answer at the bottom of the page
RATIONALE
The patient was pregnant three times. Her 4 years old child was born after 37 weeks gestation at term. She did not deliver an infant at pre-term. Her miscarriage occurred at 9 weeks gestation categorizing the baby under abortion. Do not count her current pregnancy or the miscarriage. Only count her four years old child under living children.
GTPAL SCENARIO #2
38 years old patient is currently pregnant with twins. She has 7 years old triplets who were born at 30 weeks gestation, and 10 years old child born at 39 weeks gestation. The patient had a miscarriage at 9 weeks gestation 10 years ago. What is her GTPAL?
RATIONALE
Including her current pregnancy, she was pregnant 4 times. Do not count the triplets and twins separately. Only one pregnancy went past 37 weeks so she had one term pregnancy. Her triplets were born at 30 weeks, which counts as one pre-term pregnancy. This does not count as three pre-term pregnancy.
Answer to GTPAL Scenario #1 – G – 3, T – 1, P – 0, A – 1, L – 1
Answer to GTPAL Scenario #2 – G – 4 , T – 1, P – 1, A – 1, L – 4
