G = gravida - pregnancy
P = Parity (pregnancy delivered @ >20weeks)meaning labors (Para is the number of times the uterus is emptied) broken down into the following:
T = term deliveries (#) (the number of term pregnancies – twins count as 1 pregnancy! @ > 37 weeks)
P = preterm deliveries (@ <37weeks)
A = abortions or miscarriages (spontaneous + therapeutic/elective)
L = live births
Ex: G6, P3023 means 6 pregnancies, 3 term deliveries, 0 preterm deliveries, 2 abortions/miscarriages (including early term losses), 3 living children
Ex: "a woman who has 2 living children born as preterm twins in her first pregnancy would be designated as: TPAL 0-1-0-2 - 0 term births, 1 delivery prior to 37 weeks gestation (preterm), 0 pregnancies ending in spontaneous or induced abortions, and 2 living children" (3)
New ACOG guidelines for term pregnancies (1):
The following represent the four new definitions of ‘term’ deliveries:
- Early Term: Between 37 weeks 0 days and 38 weeks 6 days
- Full Term: Between 39 weeks 0 days and 40 weeks 6 days
- Late Term: Between 41 weeks 0 days and 41 weeks 6 days
- Postterm: Between 42 weeks 0 days and beyond
Confusing terms (2):
Gravida
A woman who currently is pregnant or has been in the past, irrespective of the pregnancy outcome.
Gravidity: The number of pregnancies, current and past, regardless of the pregnancy outcome.
ISSUES
• What counts as evidence of pregnancy?
Do chemical pregnancies count?
Do physicians have to have evidence of pregnancy?
RATIONALE
• If a woman says she was pregnant and there was any evidence, should count.
• Includes chemical pregnancies
Parity
The number of pregnancies delivered at 20 weeks, 0 days or beyond, regardless of the number of fetuses, alive or dead.
ISSUES
• Fetal death certificate versus certificate of live birth
• Address confusion over multiple gestation.
• Question of viability at 20 weeks
• Include abortions after 20 weeks
RATIONALE
• Would, by definition, include abortions
• 20 weeks was decided by fetal death certificate; do not want to debate viability
~Wonder Me!
Citations:
(1) http://www.acog.org/About-ACOG/News-Room/News-Releases/2013/Ob-Gyns-Redefine-Meaning-of-Term-Pregnancy
(2) http://www.acog.org/About_ACOG/ACOG_Departments/Patient_Safety_and_Quality_Improvement/~/media/Departments/Patient%20Safety%20and%20Quality%20Improvement/201213IssuesandRationale-HistoricalDiagnoses.pdf
(3) http://sinoemedicalassociation.org/AP2/OBGYNTERMINOLOGYDEFINITION.pdf
https://manual.jointcommission.org/releases/TJC2014A/rsrc/Manual/TableOfContentsTJC/PC_2014A.pdf
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