Hi! Welcome back to my channel. This is Bonita Gracia, RN.
Today's video is for nursing students and for those who will be taking the nursing board exam. Let's talk about one of the most confusing topics in nursing, especially maternal nursing, the obstetrics core or the GPT-POM. What is the purpose of GPT-PAM?
Why is it needed? So this is important for us to determine pregnancy outcomes and is useful for us to assess Let's start! GPT-POM stands for Gravida, Parity, Term, Preterm, Abortion, Leaving, and Multiple. pregnancy. Dun muna tayo sa gravida.
Gravida means number of pregnancies. In simple terms, number of times a woman has been pregnant. Ilang beses siya nagbuntis.
So this includes previous pregnancies, current pregnancy, lagi itong nalilimutan, current pregnancy, and H-mole. Ano yung H-mole na yan? H-mole is high td4 mole, which is also known as molar pregnancy.
So during a molar pregnancy, the placental tissue develops abnormally. So this can appear as a mass of cysts. So yung embryo doesn't form or is malformed and can't survive. So this is considered a non-viable pregnancy.
Ito yung each mole yung nag-positive ka o buntis ka. Lumaki yung chan mo, nagsusuka ka lahat ng symptoms ng buntis na experience mo. However, may abnormality nakita din sa ultrasound may kita to sa ultrasound na walang embryonic disc so it is a non-viable pregnancy parity number of pregnancy deliveries that reach age of viability ano yung age of viability na yan yun is 20 weeks yung mga naipanganak nung buntis na umabot sa 20 weeks term number of full term delivered full term is 37 to 42 weeks preterm number of preterm delivered less than 37 weeks so lahat ng ipinanganak ng buntis na less than 37 weeks it is considered preterm pero take note ha it is less than 37 weeks but more than 20 weeks or yung age of viability natin kasi pag less than 20 weeks yun pinanganak, ano ang tawag dun?
Abortion na yun. There, abortion, number of pregnancies less than 20 weeks. This includes yung miscarriages, nalaglag, or H-MOL den.
Because H-MOL is considered non-viable pregnancy. Living, number of alive births or number of children living. In this part, we count multiple pregnancy as one.
We count them individually. individually example nanganak ng twins ng kambal so in living ilan yun dalawa we count it as two for m multiple pregnancy number of multiple pregnancies example twins triplets etc so kung example it natin kambal for multiple or yung m ilan yung bibilangin mo we count it as one may patrick triplets yama quadruplets yan twins we count it as one but for the leaving kung nanganak siya ng triplets sa m ang bilang mo isa sa l or leaving ang bilang mo tatlo let's try easy examples first tips from my previous vlog understand the question or the statement given mrs sharon is currently pregnant she has healthy two previous pregnancies delivered at 38 weeks no he's of abortion or fetal death the obstetric score is he might him a new statement mrs. Sharon is buntis down I own she has healthy to pregnancies delivered at 38 weeks healthy meaning pinana number hi keep them off 38 weeks yeah I love my termian so well I'm free term John wallering abortion let's proceed let's take note of the gravity the Mona then list down those pregnancies before we can count kung ilan yung PT pump. Okay, first given currently pregnant, that is considered one pregnancy.
So G1 is current pregnancy. She has healthy two daw. Two previous pregnancies delivered at 38 weeks.
G2 natin is yung unang pregnancy delivered at 38 weeks. So yung pangatlong pagbubuntis ngayon ni Sharon ay yung pangalawang pagbubuntis na na-deliver ng 38 weeks. weeks so all in all ilang beso nagbuntis tatlo so gravida is three for p party pregnancy deliveries na umabot ng age of viability or 20 weeks ilan dyan dalawa kitang kita mo si g2 at g3 so parity is 2. for the term ilan pag bumuntis yung umabot ng 37 to 42 weeks isa si g2 which is yung 38 weeks at dalawa yung pangalawang pagbubuntis niya na pinanganak ng 38 weeks dyan.
So, term is 2. For preterm, kitang-kita mo walang less than 37 weeks dyan. So, wala. Abortion, wala rin less than 20 weeks.
Walang miscarriage. So, abortion is 0. For the living, ilan yung pinanganak na nabuhay? Kita mo din, dalawa.
G1 is not counted kasi present pregnancy pa yun, hindi mo pa pinapanganak. So, what we count in leaving is the pregnancy delivered for m multiple there are no twins or triplets so zero m is zero so the obstetric score is gravida three p parity two term two preterm zero abortion zero leaving two multiple zero or it can be like this g3 p2 t2 l2 depends on the choices that you will be given in a mid lang yung mga walang count or yung mga zero. Kung napapansin nyo, bakit walang tick dun sa current pregnancy?
Bakit nga ba? For the current pregnancy, regardless kung sabihin na, kung wari, nasa 23 weeks pregnant siya, yung pinagbubuntis niya ngayon, it will only be part of the gravida kasi hindi pa naman siya pregnancy delivered, hindi pa napapanganak kasi nasa sinapupunan pa lang. Example, kung wari sinabi, Mrs. Sharon is Currently, 23 weeks pregnant.
Uy, more than 20 weeks, so counted as one parity? No. For current pregnancy, it will only be part of the gravida. Anong definition ng gravida ulit? Number of pregnancies.
Number of times na nabuntis si Sharon. Number of times na nabuntis si Sharon, ilang beses siya nagbuntis. What we are talking about? Parity, term, preterm, and multiple pregnancy is number of pregnancies delivered. Or yung mga pinanganak na regardless if alive or patay.
Next example, patient is pregnant. A year ago, she had a twin pregnancy delivered at 38 weeks, resulting in two healthy boys. The obstetric score is, let's compute for the gravida first.
Unang pagbubuntis, yung ngayon na pinagbubuntis. current pregnancy. Ano pa?
Nagkaroon daw siya ng twin pregnancy, so that is considered another gravida. Multiple pregnancy, we count it as one. So, itong twins na to, isang pagbubuntis nang yan.
So, total, ilang beses siya nagbuntis? Dalawa. Gravida is two. For parity, ilan yung umabot ng 20 weeks? Itong si 38 weeks na twin pregnancy, so, isa kay G2.
Parity is one. Term, ilan yung umabot ng term? Si 38 weeks, twin pregnancy na naman so isa lang for preterm wala no less than 37 weeks abortion wala rin leaving ngayon yung ika count natin sa leaving so meron tayong kambal considered as one pregnancy yun so gravida isa count natin yun as one gravida however sa leaving we count it individually so kung twin siya kambal daw ilan yung pinanganak na buhay? Dalawa.
For the M, or multiple pregnancy, we count it as one. Yung twin. Kasi isang pagbubuntis nang naman yan.
O, para hindi malito, kung merong kambal dyan, kung may triplets dyan, sa M at gravida, you count it as one. However, kapag living, bibilangin mo individually. Kung kambal yan, dalawa.
Kung triplets yan, tatlo. The obstetric score is gravida 2, parity 1, term 1, preterm zero abortion zero leaving two multiple pregnancy is one third example lisa is pregnant with twin girls she has a healthy four-year-old child delivered at 37 weeks Now, history of abortion or fetal death. The obstetric score is, let's count the gravida first, then list.
So, ano yung unang pagbubuntis? Count as gravida 1, yung ngayon na, huwag na natin kalimutan, yung pinagbubuntis ngayon na twins. Pangalawang pinagbuntis is yung 4-year-old delivered at 37 weeks. Healthy daw.
So, it is delivered alive at 37 weeks. So, ilan yung pinagbuntis niya na? Yung ngayong pinagbubuntis at yung pinanganak niya ng 37 weeks. So, gravida is 2. For the parity, ilan yung umabot ng 20 weeks? Isa.
CG2. So, parity is 1. Term, ilan yung abot ng 37 to 42 weeks na pinanganak? Isa rin. Term is 1. Pre-term, may pre-term ba?
Walang less than 37 weeks? So, pre-term is 0. Abortion, it indicates in the statement, wala. Abortion is zero.
Leaving, ilan yung pinanganak na buhay? Isa lang. See, four-year-old yun. So, leaving is isa.
Multiple pregnancy, ilan yung pinanganak? Nakambal na triplets, wala. So, M is zero.
The obstetric score is gravida 2, parity 1, term 1, preterm 0, abortion 0, leaving 1, and multiple pregnancy is? Zero. Tataka ka ngayon, bakit may twins naman doon? Bakit hindi kasama sa, hindi counted sa multiple pregnancy? Kita mo, current pregnancy.
So, will not count the twins as multiple pregnancy kasi hindi pa naman pinapanganak. Present pregnancy niya yung twins. So, one gravida lang din. Counted as one.
Multiple pregnancy, wala pang pinanganak na twins. nasa sinapupunan pa lang. Regardless kung sabihin na twins yung pinagbubuntis niya ngayon, it will only be part of the gravida.
Kasi hindi pa naman siya pregnancy delivered, hindi pa pinapanganak. What we are talking about, parity term, preterm, abortion, leaving, and multiple pregnancy is number of pregnancies delivered or yung mga pinanganak na. Clear? Okay, let's proceed with the next example. A 26-year-old woman had delivered two previous healthy pregnancies at 34 weeks and 40 weeks.
Next, the pregnancy was delivered at 43 weeks but died. She's now pregnant and will visit her OB. The obstetric score is, let's start with gravida ulit. Magbilang tayo kung ilang beses siya na buntis. Unang pagbuntis, yung healthy pregnancy at...
34 weeks so g1 is alive healthy the way alive birth at 34 weeks pangalawang pagbubuntis yung alive at 40 weeks next pregnancy daw was delivered at 43 weeks but died so g3 is patay died 43 weeks and she's now pregnant so buntis ngayon counted as One pregnancy rin. G4 is current pregnancy. All in all, ilan beses siya nagbuntis?
Pang-apat, including yung ngayong pagbumuntis. So, gravida is 4. For parity, ilan yung umabot ng 20 weeks? Kitang kita.
Si G1, G2, at G3. So, tatlo. Parity is 3. For term, ilan yung umabot ng 37 weeks to 42 weeks?
Dalawa, kitang-kita mo si G2 at si G3. So term is 2. Preterm, ilan yung pinanganak ng less than 37 weeks? Isa, si G1. So preterm is 1. Abortion, meron bang pinanganak dyan na less than 20 weeks? Wala.
May namatay pero hindi naman siya abortion. Kasi 43 weeks to, so abortion is 0. Living, ilan yung... pinanganak na buhay. Kitang-kita mo, ayan, no?
Dalawa. Si G1 at si G2. So, leaving is dalawa.
Si current pregnancy, hindi yan counted, ha? Kasi hindi pa pinapanganak. Okay. Ilan si multiple pregnancy?
May pinanganak ba na? Twins, triplets? Wala. So, multiple is zero.
Obstetric score is G4, gravity 4, parity 3, term 2. preterm one abortion zero living two and multiple pregnancy zero last question so let's understand patient had one previous smaller pregnancy and one previous miscarriage. She then gave birth to a live baby boy at full term. Three years ago, she had an IUFD at 40 weeks gestation.
She had another baby born dead at 32 weeks. Last pregnancy resulted to a healthy three-year-old child delivered at 38 weeks. She's worried about her current pregnancy. That's why she visited her physician. The obstetric score is, may nabasa ka, ayun, may bago kang nabasa, IUFD, bago para sayo.
Ano ba yung IUFD na yan? IUFD means intrauterine fetal death or demise. Ito yung death of fetus more than 20 weeks, age of viability, or stillbirth. Ito yung mga namamatay sa sinapupunan pa lang, or...
pinanganak na pa tayong bata. Okay, let's proceed with counting the obstetric score. Let's start with gravida. Unang pagbubuntis is molar pregnancy. What is molar pregnancy?
Age move. And another previous miscarriage daw, yun yung pangalawang pagbubuntis niya. So, G2 is abortion.
G2 is abortion. Pangatlong pagbubuntis daw, alive baby boy at full term. So, G3 is...
alive full term three years ago she had an iufd so this is the fourth pregnancy g4 is iufd at 40 weeks gestation she had another baby na naman asipag neto ah born kaso patay daw at 32 weeks so g5 natin is dead at 32 weeks Last pregnancy resulted to a healthy 2-year-old child delivered at 38 weeks. So, G6, healthy daw, meaning alive, pinanganak, buhay. G6 is alive at 38 weeks.
And now, she's currently pregnant. So, this is considered as G7. All in all, ilang beses siya nagbuntis ulit?
Pito. So, gravida is 7. Let's proceed with... Parity. Ilan dyan yung umabot ng 20 weeks or age of viability? Ayun, may isa.
Full term, si G3, one parity. May 40 weeks, si G4, pangalawa. May 32 weeks, si G5, pangatlo na.
May 38 weeks, si G6, pangapat. So, ilan lahat yan? Apat.
Parity is four. For the age mole, as what I've said, earlier this is considered a non-viable pregnancy kasi walang embryonic disc so non-viable meaning hindi siya umabot ng 20 weeks so it is not considered in parity abortion let's define abortion it is less than 22 weeks yung mga nalaglag mga pregnancy delivered at less than 20 weeks ito yung mga miscarriage natin so abot mo siya ng 20 weeks no it's less than so it's not considered as parity current pregnancy hindi pa rin pinapanganak so hindi siya kasama sa parity what we talk about parity is number of pregnancy delivered or yung mga pinanganak na that reached age of viability okay sa term ilan yung umabot ng 37 to 42 weeks cg3 cg4 cg6 so term is three so preterm preterm ilan yung preterm births less than 37 weeks but not less than 20 weeks kasi kung less than 20 weeks considered as abortion na yan so ayun may isa si g5 the dead delivered at 32 weeks 32 weeks less than 37 weeks so meron tayong isang preterm for abortion Ayun, si G2 counted as isang abortion and isama mo na si HMOL sa abortion. So, abortion is dalawa. HMOL, again, is non-viable pregnancy. Hindi siya nag-reach ng age of viability.
So, it is counted as abortion. Let's go with the living. Ilan yung pinanganak na buhay? Let's count.
There, one. G3, one to G6. So, two only. IFT is dead too. So, in the lead.
meron tayong dalawa. For multiple pregnancy, ilan yung pinanganak na twins? May twins ba dyan na sinabi? Wala. So, M is zero.
The obstetric score is gravity 7, parity 4, term 3, preterm 1, abortion 2, living 2, multiple pregnancy is zero. To summarize, these are things to remember. First, current pregnancy is in included only in gravida. So, regardless sa sabihin niya, 23 weeks current pregnant, or yung present na pinagbubuntis niya is twins, it is only included in gravida.
Hindi mo siya ika-count yung twins sa multiple kasi hindi pa naman pinapanganak. Next. Multiple pregnancy is counted as one. For example, twins, triplets, quadruplets, etc. is only counted as one.
However, in counting alive pregnancy deliveries, we count it individually. Example, for twins, sa multiple or M, you count it as one, but for the living, you count it as two. Kasi ilan yun? Dalawa.
Multiple pregnancy is counted as one pregnancy. However, for the living, we count the number of living children sa twins ilan yung pinagbuntis mo doon ilan yung pinanganak po doon dalawa next h mole or molar pregnancy is counted as one gravida one abortion that is considered a non-viable pregnancy this is different from multiple pregnancy ha molar pregnancy is h mole or high the td4 mole that is considered a non-viable pregnancy another thing to remember iufd or stillbirth is not abortion bucket in iufd defined as death of baby in the uterus more than or equal to 20 weeks for abortion it is less than 20 weeks iufd reaches its age of viability of 20 weeks So hindi siya abortion. We only classify it as abortion if it's less than 20 weeks. Abortion in IUFD has the same meaning of pregnancy loss but differs to when the pregnancy loss has occurred.
So namatay yung baby or yung fetus sa IUFD sa sinapupunan ng more than 20 weeks or 20 weeks. If the fetus died for 20 weeks or more than 20 weeks, it is considered as IUFD. But if the fetus died for less than 20 weeks, it is considered as abortion. So, they are different. The only reason we are counting this is to assess where you will classify IUFD.
In Gravida, is IUFD counted? Yes, it is considered as one pregnancy. Sa parity, counted ba si IUFD?
Yes, kasi it is, it reached the age of viability. But for abortion, it is not counted in the parity. So, therefore, another one to take note, parity, as we define number of pregnancies reached the age of viability or 20 weeks.
Regardless if alive or dead. IUFD is counted as one party. That's all for this video.
I really included samples that will make you think. So that when you encounter it on the boards, you can answer it. I'm happy to announce that we reached 1,000 subscribers in YouTube! Yay! Thank you everyone!
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