DETERMINING GRAVIDITY

AND PARITY

PREPARED BY: MAUREEN JOY GALERA

MARYCON FIA ADEL MUNOZ
 PRINCIPLES IN IDENTIFYING PARITY

1. The number of pregnancies is counted and not the number of

fetuses.
2. Abortion is not included in parity count because in abortion
the fetus is delivered before the age of viability (before 20
weeks).
3. Live birth or stillbirth is counted in parity count. Whether
the fetus is born alive or still, for as long as it has reached 20
weeks, it is counted as one parity.
 OBSTETRICAL SCORING

Gravidity – Total pregnancy

Term – Full term; total number of infants born at 37 weeks
gestation or beyond
Preterm – total number of infants born between 20 to 37
weeks gestation
Abortion – total number of pregnancies ending in abortion
(terminated before 20 weeks gestation or age of viability)
Living – the number of children currently living
SAMPLE QUESTIONS

Sara is currently 38 weeks pregnant and has a history of 1 spontaneous abortion at

12 weeks of gestation and 1 normal vaginal delivery of twin boys at 37 weeks
gestation. How would you record her GTPAL?
 G-3
 T-1- has not given birth yet
 P-0
 A-1
 L-2
Amy, a 27 years old female came to the clinic with history of missed periods and
positive urine pregnancy test at home. According to ultrasonography, she is 9 weeks
pregnant. Further reproductive history reveals that she was never pregnant before,
but used to have irregular menstrual period for the past 1 year. How would you
record this using GTPAL.
 G-1
 T-0
 P-0
 A-0
 L-0
A woman who is 13 weeks pregnant, has a history of loss of 2 previous pregnancies
at 10 weeks and 9 weeks of gestation respectively. She has 3 children, her 1 st child
was delivered via NSVD at 38 weeks. The 2nd time she delivered were twin girls at
36 weeks of gestation via LSCS due to PROM. How would you record her GTPAL?
 G- 5
 T-1
 P-1
 A-2
 L-3
 ESTIMATING EXPECTED DATE OF
DELIVERY

1. Determine the last menstrual period (LMP).

2. Consider the first day of the LMP.
3. Consider the month in numeric terms. (January – 1,
February – 2, etc.)
4. For the first three months of the year, add 12 to the
numerical value.
5. Naegele’s Formula: Subtract three months, add seven days
to the first day of the LMP, and add one year (conditional).
 AGE OF GESTATION
Age of Gestation estimates how far along you are in your pregnancy. Gestation is the period of
time between conception and birth. During this time, the baby grows and develops inside the
mother's womb. Your health care provider uses the gestational age in weeks (rather than
months) to plan your care during pregnancy. Most pregnancies last about 40 weeks from the
first day of the last menstrual period.
 The gestational age is based on the date of the last period, not the date of conception.
Because of this, a person is usually considered at least 4 weeks pregnant by the time they
actually miss a period and have a positive pregnancy test. Gestational age is the common
term used during pregnancy to describe how far along the pregnancy is. It is measured in
weeks, from the first day of the woman's last menstrual cycle to the current date. A normal
pregnancy can range from 38 to 42 weeks.
 Infants born before 37 weeks are considered premature. Infants born after 42 weeks are
considered postmature.
 Gestational age can be determined before or after birth.
 Before birth, your health care provider will use ultrasound to measure the size of the baby's head,
abdomen, and thigh bone. This provides a view on how well the baby is growing in the womb.
 After birth, gestational age can be measured by looking at the baby's weight, length, head circumference,
vital signs, reflexes, muscle tone, posture, and the condition of the skin and hair.
 If the baby's gestational age findings after birth match the calendar age, the baby is said to be appropriate
for gestational age (AGA). AGA babies have lower rates of problems and death than babies that are
small or large for their gestational age.
 The weight for full-term infants that are born AGA will most often be between 2,500 grams (about 5.5
lbs or 2.5 kg) and 4,000 grams (about 8.75 lbs or 4 kg).
 Infants weighing less are considered small for gestational age (SGA).
 Infants weighing more are considered large for gestational age (LGA).
SAMPLE QUESTIONS

Naegele’s rule sample questions:

a. During a prenatal visit a patient tells you that her last menstrual period was May
21, 2016. Based on Naegele’s rule, when is the estimated date of her delivery?
5(May) 21 2016
-3 +7 + 1
----------------------------------------------
2(Feb) 28 2017
b. During a prenatal visit a patient tells you her last menstrual period was Nov. 27,
2022. Using the Naegele’s rule when is her EDD?
11 (Nov) 27 2022
-3 + 7 + 1
---------------------------------------------
8+1 3 2023

August has 31 days (Aug 27+7days) her EDD is 09/03/2023

c. Your patient comes to you stating that she wants to know her EDD. She tells you her
EDD is May 26, 2022. Using the Naegele’s rule what is her estimated date of delivery?
5(May) 26 2022
-3 +7 + 1
---------------------------------------------
2+1 5 2023 =

26+7 days goes over to the next month so EDD is 03/05/2023

-Since February has 28 days (February 26+ 7 days= March 5, 2023)
d. Coincidentally, the next year a different patient comes to you asking what her
EDD will be if her LMP was on May 26,2023. Using the Naegele’s rule what is her
EDD?
5(May) 26 2023
-3 +7 + 1
--------------------------------------------
2 +1 4 2024
= 26+7 days goes over to the next month so her EDD is 03/04/2024
-Since February 2024 is a leap year the days of the month becomes 29 so her
EDD is (February 26 + 7days) March 4, 2024.