Gravida / Para

[CBEMT]

But this is one of those things that is so briefly covered in medic school, and then so rarely used or reviewed, that a lot of medics probably just forget the fine details.

I know I did. The few times it's been necessary, I give my report using plain language, and ask the nurses at our L+D hospital what they use when I'm writing up my report to save space.

[AnthonyM83]

I know I did. The few times it's been necessary, I give my report using plain language, and ask the nurses at our L+D hospital what they use when I'm writing up my report to save space.

Hmmm, we use it with just about every single pregnant patient...at all provider levels.

[CBEMT]

So do I, I just don't see that many pregnant patients with the places I work at. Closest thing I've had to a pregnant patient within the last 12 months was a young woman who'd very recently become un-pregnant. And that was last fall.

[spenac]

LOL. At my old service we had almost an active labor call every shift. I do not miss doing that.

[Richard B the EMT]

LOL. At my old service we had almost an active labor call every shift. I do not miss doing that.

As noted elsewhere, I've been on the ambulances from the fall of 1973. In that time, I have assisted in TWO (Count them! 2) births.

As for Gravida, Momma B (my mom) used to be a "Home Instruction" teacher, which is now under "Special Education". Some of her students over the years, were on her register for the condition of "Gravida".

I never recall ever hearing that term used in EMS.

"Para" is totally new to me in any usage other than Medics, "Para-Troopers", and certain educators, such as Lady J, my girlfriend, who is a teaching "Para-Professional".

[AnthonyM83]

I know our local EMT school teaches it.

And it's in both Mosby's and Brady's paramedic texts.

[Richard B the EMT]

I know our local EMT school teaches it.

And it's in both Mosby's and Brady's paramedic texts.

Again, I make note that local protocols are local, and might not be the protocol across the town, county, or state boundary line, or international border.

I'm BLS, not ALS, so I couldn't confirm or deny it being covered in the 2 medic books, or other medic books mentioned, and used in training.

[chbare]

Para is a well known term within the hospital environment in the United States and outside of the country. The term "para" is actually an abbreviation for the term parity. Parity in medicine obviously is a count of how many times a mother has given birth. However, most will agree that gestation beyond 20 weeks meets the requirements for "para."

You may even hear the term nullipara. This refers to a mother who for a variety of reasons has been unable to carry a baby beyond the 20 week mark. To make it more complicated, I still know a few people who break the "para" concept down into what is called the TPAL format. T: Total births, P: number of preterm births, A: Abortions (most will include spontaneous and planned), L: number of living children. For example; a mother has been pregnant two times with one spontaneous abortion and one preterm child that is still living. The TPAL score may look like this: 2-1-1-1. Clearly, this can be quite confusing.

Take care,

chbare.

Edited August 15, 2009 by chbare

[AnthonyM83]

I prefer TPAL, because it breaks it down. That's what our local perinatal center uses for their forms.

[Lone Star]

My first time through EMT-B, we were told that 'gravida' referred to the first pregnancy, and 'paragravida' referred to more than one pregnancy, regardless of the outcome of that pregnancy.

After reading the different 'definitions' that have been offered, I looked it up and this is what I've found:

Gravida/para/abortus (GPA), or sometimes just gravida/para (GP), is a shorthand notation for a woman's obstetric history.

Gravida indicates the total number of times a woman has been pregnant, regardless of whether these pregnancies were carried to term. A current pregnancy, if any, is included in this count. Para indicates the number of viable (>20 wks) births. Pregnancies consisting of multiples, such as twins or triplets, count as ONE birth for the purpose of this notation. Abortus is the number of pregnancies that were lost for any reason, including induced abortions or miscarriages. The abortus term is sometimes dropped when no pregnancies have been lost.

Therefore, the history of a woman who has had two pregnancies (both of which resulted in live births) would be noted as G2P2.

A woman who had 4 pregnancies, one of which was miscarried, is noted as G4P3A1.

Ok, so I haven't said anything that hasn't been said before. What I'm finding shocking is that while we covered childbirth in this EMT-B class (y'all already know I had to retake the course to get my license back after expiration), Emergency Care: 11th Edition makes no reference to either term.