The obstetrical assessment reveals:1. This is her third pregnancy2. Her first child was delivered at 38 weeks3. Her second child was delivered at 34 weeks. Calculate the GTPAL Score.

1. A

   31101

2. B

   31102

3. C

   31111

4. D

   32111

Appeared in: AIIMS Delhi NO- 2019

Explanation

• The GTPAL system is a standardized format to summarize a woman's obstetric history.
• G (Gravida) is 3 because the woman is in her third pregnancy.
• T (Term) is 1 because one child was born at 38 weeks (which is greater than or equal to 37 weeks).
• P (Preterm) is 1 because one child was born at 34 weeks (which is between 20 and 37 weeks).
• A (Abortion) is 0 as no pregnancy losses before 20 weeks were mentioned.
• L (Living) is 2 because she has two children from her previous pregnancies, and they are assumed to be alive.

Why Other Options Were Wrong

• Option A: This option incorrectly states there is only 1 living child (L=1). The patient has two children from two previous deliveries.
• Option C: This option incorrectly records 1 abortion (A=1) and only 1 living child (L=1). The history provides no information about an abortion, and she has two children.
• Option D: This option incorrectly records 2 term deliveries (T=2) and only 1 living child (L=1). Only one delivery was at term (38 weeks); the other was preterm (34 weeks).

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to GTPAL Scoring System in Obstetrics to guide bedside assessment, documentation, and the next nursing action.
• The GTPAL score provides a quick and comprehensive summary of a patient's obstetric history, which is essential for healthcare providers to assess potential risks and plan care for the current pregnancy.
• A history of preterm birth (P=1) is a significant risk factor for preterm birth in subsequent pregnancies, requiring closer monitoring.
• Understanding a patient's gravidity and parity helps in anticipating potential complications related to multiparity or issues from previous pregnancies.

How to Approach the Question

• First, understand what each letter in the GTPAL acronym stands for: Gravida, Term, Preterm, Abortion, Living.
• Read the patient's history carefully, extracting one piece of information at a time.
• Calculate 'G' (Gravida) by counting the total number of pregnancies, including the current one.
• Calculate 'T' (Term) by counting the number of births that occurred at or after 37 weeks.
• Calculate 'P' (Preterm) by counting births between 20 and 36 weeks 6 days.
• Calculate 'A' (Abortion) by counting pregnancy losses before 20 weeks.

Concept Tested & Keywords

• Concept Tested: GTPAL Scoring System in Obstetrics
• Stem keywords: GTPAL Score, obstetrical assessment, third pregnancy, 38 weeks, 34 weeks
• Lead-in keywords: Calculate
• Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

Question ID

QhwHQq3S4FPnUt9y2U3GVJ

Copy ID

Reference Book

E6 Obstetrics Williams p. 71-95