Gravidity and parity

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In biology and medicine, gravidity and parity are the number of times a female has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity). [1] These two terms are usually coupled, sometimes with additional terms, to indicate more details of the female's obstetric history. [2] When using these terms:

Contents

Gravidity in biology

In biology, the term "gravid" (Latin : gravidus "burdened, heavy" [4] ) is used to describe the condition of an animal (most commonly fish or reptiles) when carrying eggs internally. For example, Astatotilapia burtoni females can transform between reproductive states, one of which is gravid, and the other non-gravid. In entomology it describes a mated female insect.[ citation needed ]

Gravidity in human medicine

In human medicine, "gravidity" refers to the number of times a female has been pregnant, [1] regardless of whether the pregnancies were interrupted or resulted in a live birth. “Gravidity” is an important component of a patient’s reproductive history, as it provides insight into the risk factors that the patient has for pregnancy outcomes, such as risk for gestational diabetes, pre-ecclampsia, spontaneous abortion, preterm birth, fetal growth restriction, and more. [5] The gravidity of the patient is associated with risk for other conditions as well, including risk for breast, ovarian, and endometrial cancer. [6] Knowing a patient’s obstetric history in a prenatal assessment or early in gestation allows the patient to receive early intervention to prevent these associated risks. [5]

Terms such as "gravida 0", referring to a nulligravida, "gravida 1" for a primigravida, and so on, can also be used. The term "elderly primigravida" has also been used to refer to a female in their first pregnancy who is at least 35 years old. [7] Advanced maternal age can be a risk factor for some birth defects.

Parity in medicine

In human medicine, parity is the number of pregnancies carried by a female for at least 20 weeks (duration varies from region to region, 20 – 28 weeks, depending upon age of viability). If a female carries the fetus to viable age, even if ultimately the fetus is born deceased, this still counts as an instance of parity, as parity is based on the time of gestation prior to a birth, and not the status of the offspring once born. [8] [9]

A female who has never carried a pregnancy beyond 20 weeks is nulliparous and is called a nullipara or para 0. [10] A female who has given birth once is primiparous and is referred to as a primipara or primip. A female who has given birth two, three, or four times is multiparous and is called a multip. Grand multipara describes the condition of having given birth five or more times. [11] Grand multiparity is associated with adverse maternal and neonatal health outcomes. [12]

Like gravidity, parity may also be counted. A female who has given birth one or more times can also be referred to as para 1, para 2, para 3, and so on.

Viable gestational age varies from region to region.

Nulliparity

A nulliparous ( /nʌlˈɪpərəs/ ) female (a nullipara or para 0) has never given birth. It includes females who have experienced spontaneous miscarriages and induced abortions before the mid-point of pregnancy, but not females who have experienced pregnancy loss after 20 weeks. Nulliparity has been implicated in the development of various complications during pregnancy including preeclampsia, gestational diabetes and pre-term labor. [5]

Long-term and permanent nulliparity ( /ˌnʌlɪˈpærɪti/ ) are risk factors for breast cancer. For instance, a meta-analysis, published in 1990, of 8 population-based studies in the Nordic countries found that never giving birth was associated with a 30% increase in the risk of breast cancer compared with females who have given birth, and for every 2 births, the risk was reduced by about 16%. Females having their first birth after the age of 35 years had a 40% increased risk compared to those with a first birth before the age of 20 years. [13]

Parity in biology

In agriculture, parity in biology is a factor in productivity in domestic animals kept for milk production. Animals that have given birth once are described as "primiparous"; those that have given birth more than once are described as "pluriparous". [14] [15] Those that have given birth twice may also be described as "secondiparous", in which case "pluriparous" is applied to those that have given birth three times or more.

Recording systems

A number of systems are incorporated into a female's obstetric history to record the number of past pregnancies and pregnancies carried to viable age. These include:

Though similar, GPA should not be confused with the TPAL system, the latter of which may be used to provide information about the number of miscarriages, preterm births, and live births by dropping the "A" from "GPA" and including four separate numbers after the "P", as in G5P3114. This TPAL form indicates five pregnancies, with three term births, one preterm birth, one induced abortion or miscarriage, and four living children. [19]

Some established journals have used GTPAL system ignoring "T", and even rearranging the letters within the remaining combination [this effectively reduces it to GPLA system. For instance G3P1L1A1]. [20] Thus, individual choices of authors also seem to matter, which recognized journals often ignore.

Criticism

In obstetrics, the term can lead to some ambiguity for events occurring between 20 and 24 weeks, [21] and for multiple pregnancies. [22]

Related Research Articles

Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The most common reasons women give for having an abortion are for birth-timing and limiting family size. Other reasons reported include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.

Dilationand curettage (D&C) refers to the dilation of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus, remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the uterus causing abnormal cycles by scraping and scooping (curettage). It is a gynecologic procedure used for treatment and removal as well as diagnostic and therapeutic purposes, and is the most commonly used method for first trimester abortion or miscarriage.

<span class="mw-page-title-main">Ectopic pregnancy</span> Female reproductive system health issue

Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions, the fetus is unable to survive.

<span class="mw-page-title-main">Miscarriage</span> Natural premature termination of pregnancy

Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can survive independently. Miscarriage before 6 weeks of gestation is defined as biochemical loss by ESHRE. Once ultrasound or histological evidence shows that a pregnancy has existed, the term used is clinical miscarriage, which can be "early" or "late". Spontaneous fetal termination after 20 weeks of gestation is known as a stillbirth. The term miscarriage is sometimes used to refer to all forms of pregnancy loss and pregnancy with abortive outcomes before 20 weeks of gestation.

<span class="mw-page-title-main">Live birth (human)</span> Event that a fetus is born alive with heartbeats or respiration

In human reproduction, a live birth occurs when a fetus exits the mother showing any definite sign of life such as voluntary movement, heartbeat, or pulsation of the umbilical cord, for however brief a time and regardless of whether the umbilical cord or placenta are intact. After the fetus is expelled from the maternal body it is called a neonate. Whether the birth is vaginal or by caesarean section, and whether the neonate is ultimately viable, is irrelevant.

<span class="mw-page-title-main">Stillbirth</span> Death of a fetus before or during delivery, resulting in delivery of a dead baby in some manner

Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can often result in the feeling of guilt or grief in the mother. The term is in contrast to miscarriage, which is an early pregnancy loss, and sudden infant death syndrome, where the baby dies a short time after being born alive.

Late termination of pregnancy, also referred to politically as third trimester abortion, describes the termination of pregnancy by inducing labor during a late stage of gestation. In this context, late is not precisely defined, and different medical publications use varying gestational age thresholds. As of 2015, in the United States, more than 90% of abortions occur before the 13th week, 1.3% take place after the 21st week, and less than 1% occur after 24 weeks.

<span class="mw-page-title-main">Obstetric ultrasonography</span> Use of medical ultrasonography in pregnancy

Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a standard part of prenatal care in many countries, as it can provide a variety of information about the health of the mother, the timing and progress of the pregnancy, and the health and development of the embryo or fetus.

Fetal viability is the ability of a human fetus to survive outside the uterus. Viability depends upon factors such as birth weight, gestational age, and the availability of advanced medical care. In low-income countries, more than 90% of extremely preterm newborns die due to a lack of said medical care; in high-income countries, the vast majority of these newborns survive.

In obstetrics, gestational age is a measure of the age of a pregnancy taken from the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method, if available. Such methods include adding 14 days to a known duration since fertilization, or by obstetric ultrasonography. The popularity of using this measure of pregnancy is largely due to convenience: menstruation is usually noticed, while there is generally no convenient way to discern when fertilization or implantation occurred.

<span class="mw-page-title-main">Pregnancy</span> Time of offspring development in mothers body

Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.

Dilation and evacuation (D&E) or dilatation and evacuation is the dilation of the cervix and surgical evacuation of the uterus after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.

Prenatal development involves the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal development until birth.

<span class="mw-page-title-main">Complications of pregnancy</span> Medical condition

Complications of pregnancy are health problems that are related to, or arise during pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal disorders. While some complications improve or are fully resolved after pregnancy, some may lead to lasting effects, morbidity, or in the most severe cases, maternal or fetal mortality.

The estimated date of delivery (EDD), also known as expected date of confinement, and estimated due date or simply due date, is a term describing the estimated delivery date for a pregnant woman. Normal pregnancies last between 38 and 42 weeks. Children are delivered on their expected due date about 4% of the time.

The following outline is provided as an overview of and topical guide to obstetrics:

<span class="mw-page-title-main">Products of conception</span>

Products of conception, abbreviated POC, is a medical term used for the tissue derived from the union of an egg and a sperm. It encompasses anembryonic gestation which does not have a viable embryo.

Definitions of abortion vary from one source to another. Abortion has many definitions that can differ from each other in significant ways. Given the contentious nature of abortion, lawmakers and other stakeholders often face controversy in defining abortion. Language referring to abortion often reflects societal and political opinions . Influential non-state actors like the United Nations and the Roman Catholic Church have also engendered controversy over efforts to define abortion.

Early pregnancy bleeding is vaginal bleeding before 14 weeks of gestational age. If the bleeding is significant, hemorrhagic shock may occur. Concern for shock is increased in those who have loss of consciousness, chest pain, shortness of breath, or shoulder pain.

Abortion in Ghana is banned except when there is a valid exemption. The abortion should also be conducted only at a government hospital; registered private hospital, clinics registered under the Private Hospitals and Maternity Homes Act, 1958 and a place approved by the Minister of Health by a Legislative Instrument. Illegal abortions are criminal offenses subject to at most five years in prison for the pregnant woman who induced said abortion, as well as for any doctor or other person who assisted this pregnant woman in accessing, or carrying out, an abortion. Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.

References

  1. 1 2 Borton C, Tidy C, Payne J (November 12, 2009). "Gravidity and Parity Definitions (and their Implications in Risk Assessment)". Patient.info. Retrieved June 26, 2013.
  2. ↑ Creinin MD, Simhan, HN (Mar 2009). "Can we communicate gravidity and parity better?". Obstetrics and Gynecology. 113 (3): 709–11. doi:10.1097/AOG.0b013e3181988f8f. PMID   19300338.
  3. 1 2 Cunningham G (2005). William Obstetrics (PDF) (22 ed.). McGraw-Hill Companies. p. 121. ISBN   978-0-07-141315-2. Archived from the original (PDF) on 2 February 2017. Retrieved 19 August 2016.
  4. ↑ Oxford English Dictionary[ page needed ]
  5. 1 2 3 Stubblefield PG, Coonrod DV, Reddy UM, Sayegh R, Nicholson W, Rychlik DF, Jack BW (1 December 2008). "The clinical content of preconception care: reproductive history". American Journal of Obstetrics and Gynecology. 199 (6, Supplement B): S373–S383. doi:10.1016/j.ajog.2008.10.048. PMID   19081433.
  6. ↑ Troisi R, Bjørge T, Gissler M, Grotmol T, Kitahara CM, Myrtveit Sæther SM, Ording AG, Sköld C, Sørensen HT, Trabert B, Glimelius I (May 2018). "The role of pregnancy, perinatal factors and hormones in maternal cancer risk: a review of the evidence". Journal of Internal Medicine. 283 (5): 430–445. doi:10.1111/joim.12747. PMC   6688839 . PMID   29476569.
  7. ↑ Brassil MJ, Turner MJ, Egan DM, MacDonald DW (June 1987). "Obstetric outcome in first-time mothers aged 40 years and over". European Journal of Obstetrics & Gynecology and Reproductive Biology. 25 (2): 115–20. doi: 10.1016/0028-2243(87)90114-6 . PMID   3609426.
  8. ↑ "Definition of PARITY".
  9. ↑ https://demo.oppia-mobile.org/media/courses/ldc-all/02_12181_en.html%5B%5D
  10. 1 2 F. Gary Cunningham, 2005. Williams Obstetrics, 22nd Edition, McGraw-Hill Companies.[ page needed ]
  11. ↑ "Definition of Grand multipara". medicinenet.com.
  12. ↑ Sara Ellis Simonsen, CNM, MSPH, PhDMichael W Varner, MD (June 2023). "Grand Multiparity". Up To Date . Retrieved 2024-11-11.{{cite web}}: CS1 maint: multiple names: authors list (link)
  13. ↑ Ewertz M, Duffy SW, Adami HO, et al. (1990). "Age at first birth, parity and risk of breast cancer: A meta-analysis of 8 studies from the Nordic countries". International Journal of Cancer. 46 (4): 597–603. doi:10.1002/ijc.2910460408. PMID   2145231. S2CID   32387496.
  14. ↑ Mehrzad J, Duchateau L, Pyörälä S, Burvenich C (December 2002). "Blood and Milk Neutrophil Chemiluminescence and Viability in Primiparous and Pluriparous Dairy Cows During Late Pregnancy, Around Parturition and Early Lactation". Journal of Dairy Science. 85 (12): 3268–3276. doi: 10.3168/jds.S0022-0302(02)74415-9 . hdl: 1854/LU-149282 . PMID   12512600.
  15. ↑ Vecchio D, Neglia G, Rendina M, Marchiello M, Balestrieri A, Di Palo R (January 2007). "Dietary influence on primiparous and pluriparous buffalo fertility". Italian Journal of Animal Science. 6 (sup1): 512–514. doi: 10.4081/ijas.2007.1s.512 . S2CID   85810948.
  16. ↑ Hatfield, Nancy, N. Jayne Klossner (2006). Introductory maternity & pediatric nursing. Hagerstown, MD: Lippincott Williams & Wilkins. p.  142. ISBN   978-0-7817-3690-9.
  17. ↑ "The OB-GYN Clerkship: Your Guide to Success" (PDF). Loyola University Chicago.
  18. 1 2 Lippincott Manual of Nursing Practice Series: Assessment. Hagerstwon, MD: Lippincott Williams & Wilkins. 2006. p. 385. ISBN   978-1-58255-939-1.
  19. ↑ Bardsley CR (2011). "Normal Pregnancy". In Tintinalli JE, Kelen GD, Stapczynski JS (eds.). Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7th ed.). New York: McGraw-Hill. Archived from the original on 2013-01-20. Retrieved 2013-06-19.
  20. ↑ Gundabattula SR, Pochiraju M (2014). "Primary abdominal pregnancy in the uterosacral ligament with haemoperitoneum: a near miss". J Clin Diagn Res. 8 (5): OD08-9. doi: 10.7860/JCDR/2014/7902.4381 . PMC   4080042 . PMID   24995221.
  21. ↑ Creinin MD, Simhan HN (March 2009). "Can we communicate gravidity and parity better?". Obstet Gynecol. 113 (3): 709–11. doi:10.1097/AOG.0b013e3181988f8f. PMID   19300338.
  22. ↑ Opara EI, Zaidi J (October 2007). "The interpretation and clinical application of the word 'parity': a survey". BJOG. 114 (10): 1295–7. doi:10.1111/j.1471-0528.2007.01435.x. PMID   17877683. S2CID   44999235.
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