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Gravida / Para

22 posts in this topic

Posted · Report post

I was recently told that the common EMS definitions of all pregnancies versus live births (Gravidity vs Parity) seen in many textbooks is not consistent with what hospitals and other healthcare providers (like L&D nurses) use. Apparently, hospitals use Parity to mean how many times she has been pregnant over 20 weeks (or similar time period...24 weeks, etc) regardless of stillborns or miscarriages.

I think the common EMS definition I've heard from several places is useful to use, but it's inappropriate to report GP to a receiving nurse/doctor using a different definition (even if they're going to eventually ask patient themselves...in some emergent conditions it might not be possible right away).

Maybe someone who works both in EMS and hospital environment can clear things up for me.... Thanks.

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Posted · Report post

This is a topic that often causes confusion. Gravida simply means the number of times you had a bun or buns in the oven. Twins only count once. Para can be a bit more on the complicated side. Para means that you were able to carry that bun or buns long enough to be considered viable. The exact definition of para varies somewhat from source to source. However, most would agree that para is at least 20 or more weeks.

Take care,

chbare.

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Posted (edited) · Report post

Someone mixed up their definitions. The 20-week thing is the definition of para, not gravida. Gravida applies to any conception. However, they are not considered para until 20 weeks of gestation, regardless of whether born alive or stillborn.

EDIT: chbare beat me to it.

Edited by Dustdevil

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Posted · Report post

I think we're all on the same page as far as which one is Para and which Grava (unless I'm having a semi-dyslexic moment?).

What concerns me is that EMS books (including my Bledsoe's Brady book) are giving an incomplete definition of Para (live births instead of viable pregnancies).

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Posted · Report post

In the field and even in our hospitals para is used for live births. Then abortion is used for any miscarriage (spontaneous abortion ) or intentional abortion. So I get a patient that is G9P6A2, breaks down as, 9 pregnancy's, 6 live births, 2 abortions of some sort, and 1 in the oven.

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Posted · Report post

Here we break it down as follows:

Live births: only pertinent if still born carried full term or late term abortion (ie post 20 weeks) *note also make sure to include any children deceased in later years in this count !

Para: delivered babies in total

Gravida: how many times pregnant

So say you had a woman with a full term carried still born, 2 viable kids, and 2 abortions

I would count her as 2 Live birth, 3 Para, 5 Gravida

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Posted · Report post

Local protocols and practices are, for me, anyway, ask how many times pregnant, and how many live births. If they don't match, gently (!) ask how many aborts and miscarriages ("Sorry, I have to ask").

If birth is imminent, never mind, do what ya gotta do.

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Posted (edited) · Report post

... The exact definition of para varies somewhat from source to source. However, most would agree that para is at least 20 or more weeks.

Well I came out at 24 ... (maybe it was 26) .... guess that's why I'm working on becoming a paramedic huh? :lol::lol:

Edited by kiwimedic

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Posted · Report post

For the people who work in hospitals and use Parity to mean pregnancies that made it over a certain number of weeks....is the same definition used in all hospital's you've worked in? Is it in your textbooks? Or could it be a regional thing?

Basically my EMT friend is in nursing school and was surprised to find she was being taught a different definition than what she'd been using when reporting to nurses all her time as an EMT. And the nurses who work at the hospital she's doing clinicals at have no idea EMTs/Paramedics are taught a different definition.

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Posted · Report post

Directly from my OB/Gyn nursing textbook:

Maternal Newborn Nursing, Third Edition, Olds, London, Ladewig, 1988

Para: Delivery after 20 weeks of gestation (pregnancy) regardless of whether the fetus is born alive or dead.

I don't recall what my paramedic textbook said. I don't recall being surprised by any change in definition in nursing school though. 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.

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