A 27-year-old female, 16-week pregnant, has 2-year-old twins, who were born at 39 weeks gestation and a 5-year-old who was born at 40 weeks, she had no history of abortion what is her GTPAL score?

1. A

   G=3, T=2, P=0, A=0, L=3

2. B

   G=3, T=1, P=0, A=2, L=3

3. C

   G=3, T=2, P=2, A=0, I=3

4. D

   G=3, T=1, P=0, A=0, L=2

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

• The GTPAL score is a comprehensive system to summarize a woman's pregnancy history.
• G stands for Gravida, the total number of times the woman has been pregnant. In this case, she is currently pregnant (1), had a pregnancy with twins (1), and a pregnancy with her 5-year-old (1), totaling G=3.
• T stands for Term births, which are deliveries at 37 weeks or later. The twins were born at 39 weeks (1 term birth) and the 5-year-old at 40 weeks (1 term birth), totaling T=2.
• P stands for Preterm births (before 37 weeks). She has had none, so P=0.
• A stands for Abortions or miscarriages (before 20 weeks). She has had none, so A=0.
• L stands for Living children. She has twins (2) and a 5-year-old (1), totaling L=3.

Why Other Options Were Wrong

• Option B: This option incorrectly calculates Term births (T) as 1 and Abortions (A) as 2. The woman had two term births (the twins pregnancy and the 5-year-old's pregnancy), and no abortions.
• Option C: This option incorrectly calculates Preterm births (P) as 2 and uses 'I' instead of 'L'. Both previous births were at term (39 and 40 weeks), so there were no preterm births. The standard acronym is GTPAL.
• Option D: This option incorrectly calculates Term births (T) as 1 and Living children (L) as 2. She had two term births and has three living children.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The concept tested is the calculation of the GTPAL score, which is a standard method for documenting a woman's obstetric history as background academic context rather than a clinical decision trigger.
• Accurate GTPAL scoring is fundamental in obstetrics for quickly understanding a patient's past pregnancy outcomes, which can influence risk assessment and management in the current pregnancy.
• A history of preterm births (P), for example, would place the current pregnancy at higher risk for the same, prompting closer monitoring and potential interventions.
• The 'L' value provides a quick count of living children, which can be important for social and psychological assessment and support.

How to Approach the Question

• First, understand what each letter in the GTPAL acronym represents: G (Gravida), T (Term), P (Preterm), A (Abortion), L (Living).
• Read the clinical scenario carefully, identifying each pregnancy and its outcome.
• Calculate each component systematically. Remember that the current pregnancy counts towards 'G'.
• Pay close attention to the rule for multiple births (like twins): they count as one pregnancy (G) and one birth event (T or P), but are counted as multiple children under 'L'.
• Check the gestational ages provided to correctly classify births as Term (≥37 weeks) or Preterm (<37 weeks).
• Assemble the final score and match it to the given options.

Concept Tested & Keywords

• Concept Tested: The concept tested is the calculation of the GTPAL score, which is a standard method for documenting a woman's obstetric history.
• Stem keywords: GTPAL score, pregnant, twins, gestation, abortion
• Lead-in keywords: what is her
• Clinical cues: Current pregnancy at 16 weeks: This counts as one Gravida.
• Clinical cues: Twins born at 39 weeks: This counts as one Gravida, one Term birth, and two Living children.

Question ID

QH1ZCjw8_DCsBztSgcapHb

Copy ID

Reference Book

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 27-35