A nurse is collecting history from an antenatal mother. This is her third pregnancy. She has had two pregnancy losses, one at 8 weeks, and the other one at 28 weeks. The nurse would document her obstetric score as:

1. A

   G3, P1, A1

2. B

   G3, P2, A1

3. C

   G3, P0, A2

4. D

   G3, P1, A2

Appeared in: UPUMS Nsg officer-2023

Explanation

• The correct obstetric score is G3, P1, A1, which accurately reflects the patient's history using the standard GPA system.
• Gravida (G) refers to the total number of pregnancies, including the current one. Since this is her third pregnancy, G is 3.
• Para (P) refers to the number of pregnancies carried to 20 weeks of gestation or more, regardless of the outcome (live birth or stillbirth). The loss at 28 weeks counts as one para, so P is 1.
• Abortus (A) refers to the number of pregnancies lost before 20 weeks of gestation. The loss at 8 weeks counts as one abortion, so A is 1.

Why Other Options Were Wrong

• Option B: This option incorrectly counts two pregnancies as reaching viability. The current pregnancy is not yet included in the para score.
• Option C: This option incorrectly classifies the 28-week loss as an abortion and fails to count it as a para.
• Option D: This option incorrectly counts the 28-week loss as an abortion. Only the 8-week loss is counted in the abortus score.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Calculation of obstetric score using the Gravida, Para, Abortus (GPA) system to guide bedside assessment, documentation, and the next nursing action.
• Accurate documentation of obstetric history is fundamental in antenatal care to identify potential risks for the current pregnancy, such as preterm labor or recurrent pregnancy loss.
• A history of a second-trimester loss (28 weeks) alerts the healthcare team to monitor for signs of preterm labor, cervical insufficiency, or other complications more closely in the current pregnancy.
• What if? If the second loss had occurred at 19 weeks instead of 28, the score would be G3, P0, A2, as both losses would be considered pre-viable abortions.

How to Approach the Question

• First, determine the total number of pregnancies to determine the Gravida (G). The question states this is her third pregnancy, so G=3.
• Second, analyze the outcomes of the previous pregnancies based on the 20-week viability threshold.
• Count any pregnancy ending before 20 weeks as an 'Abortus' (A). The loss at 8 weeks makes A=1.
• Count any pregnancy ending at or after 20 weeks as 'Para' (P). The loss at 28 weeks makes P=1.
• Combine the calculated G, P, and A values to find the correct option.

Concept Tested & Keywords

• Concept Tested: Calculation of obstetric score using the Gravida, Para, Abortus (GPA) system.
• Stem keywords: antenatal mother, third pregnancy, pregnancy losses, 8 weeks, 28 weeks, obstetric score
• Lead-in keywords: document her obstetric score as
• Clinical cues: Third pregnancy indicates G=3.
• Clinical cues: Loss at 8 weeks is an abortion (A=1).

Question ID

QDG3BxRPK4tJgJONCdAise

Copy ID

Reference Book

E6 Obstetrics Williams p. 71-95