What is the obstetric formula of a woman who is presently pregnant with twin pregnancy, is pregnant for the 4th time and had previous 2 live birth and 1 abortion?

1. A

   G4 T2P0A1L2

2. B

   G4P1A1

3. C

   G3P2A1

4. D

   G4P2A1

Appeared in: Hariyana-CHO-2021

Explanation

• The GPA system is a common method for recording obstetric history, representing Gravida, Para, and Abortus.
• Gravida (G) is the total number of pregnancies. The woman has had 2 live births, 1 abortion, and is currently pregnant, making a total of 4 pregnancies (G4).
• Para (P) is the number of pregnancies reaching viability (20+ weeks). The 2 previous live births count as 2 viable pregnancies (P2). A twin pregnancy counts as a single para upon delivery.
• Abortus (A) is the number of pregnancy losses before 20 weeks. The woman had 1 abortion (A1).
• Combining these elements results in the correct formula: G4P2A1.

Why Other Options Were Wrong

• Option A: This option uses the more detailed GTPAL system. While G4, A1, and L2 are correct, it incorrectly assumes that both previous live births were term (T2) and none were preterm (P0). The question does not provide this information, making this option an assumption.
• Option B: This option incorrectly states Para (P) as 1. The woman has had two previous pregnancies that resulted in live births, meaning she has a parity of 2.
• Option C: This option incorrectly states Gravida (G) as 3. Gravida includes the total number of pregnancies, including the current one. With two previous live births, one abortion, and the current pregnancy, she is Gravida 4.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Obstetric History and Formulas (GPA and GTPAL) as background academic context rather than a clinical decision trigger.
• Accurate documentation of obstetric history using formulas like GPA or GTPAL is fundamental in antenatal care. It provides a quick, standardized summary of a patient's past pregnancy outcomes.
• This history is crucial for risk assessment. For example, a history of multiple abortions (high A value) might indicate a need to investigate for recurrent pregnancy loss, while high parity (high P value) can be associated with risks like postpartum hemorrhage.
• The formula helps healthcare providers anticipate potential complications in the current pregnancy and prepare for delivery accordingly.

How to Approach the Question

• First, identify the components of the woman's obstetric history provided in the question: current pregnancy status, number of previous pregnancies, and their outcomes (live births, abortions).
• Recall the definitions for the terms in obstetric formulas: Gravida (G), Para (P), and Abortus (A).
• Calculate 'G' (Gravida): Count all pregnancies, including the current one. Here, it's 2 (live births) + 1 (abortion) + 1 (current) = 4.
• Calculate 'P' (Para): Count the number of pregnancies that reached viability (20+ weeks). The 2 live births count as 2. The current twin pregnancy does not count towards Para until after delivery.
• Calculate 'A' (Abortus): Count the number of pregnancies lost before 20 weeks. Here, it's 1.
• Assemble the formula: G4, P2, A1.

Concept Tested & Keywords

• Concept Tested: Obstetric History and Formulas (GPA and GTPAL)
• Stem keywords: obstetric formula, pregnant, 4th time, twin pregnancy, live birth, abortion
• Lead-in keywords: What is
• Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

Question ID

Q0ZRZkeS_1LcIDWwgSM_xj

Copy ID

Reference Book

E6 Obstetrics Williams p. 71-95

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