Nursing 351 OB Terminology: Gravida, Para, Trimester & Abbreviations

Hello and welcome to your first mini lecture of nursing 351. I'm Professor Zeller. I can't wait to meet you all in

class. Um, and if you are not familiar with mini lectures, this is a method that we integrate in this course to

provide an overview of some of the content that we will be discussing in class for that class session. Um, some

of this material if you have read the textbook, you will be vaguely familiar with to start. Um,

but if we give you all of the basic information prior to class, then we can spend more class time applying that

information to really hit to those higher levels of learning and understanding.

So, this first mini lecture is really going to do um just an overview of a lot of terminology for OB.

OB kind of speaks its own language. We have um a lot of terms that aren't used in other specialties and we also have a

lot of abbreviations that are very common. Um some of them are specific to our specialty and some are abbreviations

you might see in other areas of nursing but mean different things. um we use a lot of shortorthhand and we

categorize a lot of um different aspects of patients assessments, patient care, etc.

So, we're going to go through some of that terminology. Um and if you have a working understanding of some of these,

then when you get to clinical or when you start SIM and you come to class, um it it'll bring a lot more context to

what we're talking about. So we have different areas within OB. This is also um how we divide up the content in the

course and the order of which we will cover it in. So PP is postpartum. So this is after birth after delivery of a

baby. Um and if anybody just thought, wait, we're starting with postpartum. We're working backwards. We absolutely

are. And we do that on purpose. Um we start with postpartum because a postpartum woman is the closest

that you have started with in assessment and skills. So, you were taught to do a headto toe on a normal adult human. Um,

as far as OB patients go, that is the closest to a postpartum patient. They're a one single adult human. Um, and they

have some specific changes that have taken place in their body that we are going to pay attention to after

childirth. IP is intraartum. So that means during the labor process, labor and delivery,

we go to that uh portion of OB next because when we put a human inside of a human, things start to get a little more

complicated. So we start with postpartum where it's a little easier and then we work our way through the labor and

delivery process. A then is antipartum. That is the duration of pregnancy. So when a patient gets pregnant, they are

then antipartum. when they go into labor, they become an intrapartum patient and then after they deliver,

they become a postpartum patient. So, we do work work through those backwards in the course. I know that seems a little

bit confusing right now, but I promise it's the easiest way to learn the content. NB is then newborn and newborn

is a term that um consists of the neonate from birth up through 30 days of life. So, we cover what to know about

newborns for the first 30 days of life. pediatrics picks up from there on. So, we only cover up to 30 days in this

course. And then WH is our abbreviation for women's health. So, that encompasses women's health outside of just pregnancy

um and delivery. And then we take it from there. So, then when we talk about pregnancy, there are 40 weeks of

pregnancy essentially from the time it's dated until the estimated due date. And then someone made it complicated and

took the number 40 and decided that we needed three trimesters. Um, so none of them are quite even, but

we have our first, second, and third trimesters. So what's important to know about those is when patients move from

one to the next. So the first trimester is from conception up until 12 weeks and 6 days gestation. So when you are dating

a pregnancy, we always date it in weeks and days. If you see just a week marker, if it just says 37 weeks, usually that

just means 37 weeks even. Um, so up until 12 weeks 6 days, the patient's in their first trimester. Therefore, the

second trimester starts at 13 weeks and continues through 27 weeks 6 days. And the third trimester starts at 28 weeks

and goes through to delivery. The easiest way to remember these is if you can remember the start point of the

second and third trimester, 13 and 28, then that'll keep all your other categories correct. So 13 weeks starts

your second trimester, third trimester starts 28 weeks. And if you ever hear the term fourth trimester, that's what

we affectionately call the postpartum period. So obviously trimester means three and there is no fourth trimester,

but it lasts almost as long. So we call it a fourth trimester and that's what we refer to as postpartum.

Gravidas and paras. This is terminology very specific to OB. Um this is a shorthand way with categories to

condense a patient's OB history, their abstetric history. So the term gravida means the total number of pregnancies

that a patient has had in her lifetime regardless of the outcome of the pregnancies. So just total number of

pregnancies. Parah then is the number of pregnancies that they carry past the 20we mark. And

you'll note as we move through these 20 weeks is kind of um a significant time within the pregnancy. So the halfway

point. For example, if a patient is a G2 P1, that means they've had two total pregnancies and they've had one delivery

after 20 weeks. And if any of you are thinking, well, what happened to the other pregnancy? That probably means

she's pregnant right now. So she's on her second pregnancy. She's had one delivery past 20 weeks.

So sometimes you'll just see this GMP number and that's the shorthand and that's what it means. If you see four

numbers after the P for parah, there are four categories. Term, pre-term, abortion, living, tal to keep it short.

Term means the pregnancy ended on or after 37 weeks. So a pregnancy that carries up to 37 weeks and makes it past

that is considered a term pregnancy or a fullterm pregnancy. Preterm therefore is under 37 weeks. But again that 20 week

mark is significant. So 20 weeks to 36 weeks and 6 days is considered a preterm delivery.

An abortion is any pregnancy ending prior to 20 weeks. And an abortion is a medical term that is inclusive of

spontaneous abortions, often called miscarriages, and induced or elective abortions, which are medically or

surgically um completed. All of those go into the same abortion category. Living is the total number of living

children that that patient has. Um, most of the time that coincides with the total of term and preterm, but sometimes

it doesn't, especially when we get into multiples. Um, and we will get into the nitty-gritty of how to assign these

numbers and categories when we get more to the anopartum um, portion of the course. But for

example, if there are four numbers after the parah. So G2P1 01 means two total pregnancies because that first category

is our T for term, one term delivery, no pre-term deliveries, no abortions, one living child, and again, she's currently

pregnant. So we just extrapolated the example from the top to the one on the bottom to include all four categories.

Um again we will revisit this and delve a little deeper into it when we hit the anopartum content of the course but when

you go to clinical or we're giving you um report for simulation we will typically report the G's and P's for a

patient in that information. So more categories for outcomes of pregnancies. Um so you know in the in

the par we just talked about we had term and preterm. We also have in addition to term or fullterm being the same pre-term

and then we have late pre-term and we have postterm. So we said term or fullterm encompasses everything 37 weeks

and beyond. We actually cut that off at just under 42. So 37 weeks to 41 and 6 days is term or fullterm.

Pre-term we said stays the same. 20 weeks to 36 and 6. But if you hear the term late pre-term, that is from the

34th week up through that 36 and six. That is more important for the neonate than it is for mom. A preterm delivery

is a pre-term delivery and more concerned as far as risk for future pregnancies. But a pre-term baby prior

to 34 weeks is almost always going to need NICU admission or at least special care admission and a lot of support.

Whereas an infant born in the late preterm period, they have a different um a different set of needs. A lot of times

they look and act much like a full-term baby. Um but they are at a high risk for respiratory issues and hypoglycemia and

difficulty maintaining their temperature and some other um complications. So we treat them a little bit differently, but

they might not always need niku or special care admission. They might be able to stay with mom. Postterm is

actually 42 weeks or more. So, you know, when we're talking about term or fullterm goes up to that 41 week, 6

days, postterm is technically 42 weeks or more. And um most care providers will not let patients go past that 42 week

mark. There are some significant risks that increase after 42 weeks, um namely still birth that will prompt induction

or delivery prior to that 42 week mark. But those are the different categories um for outcomes of pregnancy.

So then we move on to some common abbreviations that you will see um written in notes or um in report or

you'll hear when discussing patients and how they delivered or other terms for their care.

SVD is spontaneous vaginal delivery. You the patient came in and delivered vaginally without any um assistance from

devices or any any um extra manipulation kind of an operative vaginal delivery means baby still exited the same route

but we might have had to use a vacuum or forceps or something um manipulative to help baby out in that manner.

CS is the shortand for cescareian section. Um so that is obviously not the vaginal route. That is the surgical

route to deliver a baby through the abdomen. Um I affectionately call it popping the sunroof and then we get baby

out that way. ROM. So um in general you know med surge your headto toe kind of stuff ROM usually stands for

range of motion and that is not what it means in OB. So ROM is actually rupture of membranes. That means the fluid

around the baby that is um held in place by the amniotic membrane. That membrane ruptures or opens and the fluid come

starts to come out. This is um in lay terms when their water breaks. Um so rupture of membranes is um rom and then

we have a and srom. So if we know that rupture of membranes is the ROM, our AOM is artificial rupture of membranes.

Meaning we did something physically once mom is in labor or she's in the hospital for an injection or whatever that might

be. We ruptured her membranes um by a medical procedure versus SROM, but just spontaneous rupture of membranes. So her

water broke on her own. Um, contrary to what is seen on TV and movies and everything else in media, um, it's

always portrayed that the pregnant woman, oh, her water breaks and then she's in labor and she goes to the

hospital and has a baby. Um, that's actually not accurate for a lot of people. Um, o about 50% of women, their

membranes do not rupture on their own. We rupture them for them during labor or just prior to pushing or etc. or

sometimes they'll rupture once they are in labor or we're inducing them. Um but it is just as often as not that that

does not happen all by itself. So sizes of newborns at birth. So a full-term baby approximate size is

anywhere from 2500 g to 4,000 g. Um and I know here in the US we don't like gems simpler. Um, so for those who want to

see that in pounds, that's roughly 5 1/2 lb to 8 and 3/4 lb. But we do weigh babies in grams. Um, we do that for a

couple of reasons. One, because they don't they don't weigh a whole lot, right? They're really tiny. Um, it's a

more intricate measurement and it makes calculating weight loss a lot easier or simpler. Um, because all newborns will

lose some weight at birth. We expect that. Um, so roughly 5 1/2 lb to 8 and 3/4 lb. Now, that is a really large

range. I know it doesn't seem like it, but it is a large range. And a baby who weighs 5 1/2 lb versus a baby that

weighs 8 lb looks drastically different. Now, to an adult or even an older child, a 3 lb difference is insignificant for

the most part. Um, but when three pounds is 50% of your weight, makes a really big difference in what babies appear um

when they're born depending on their weight. their gestational age at delivery. So what we calculate on their

um weeks and days of pregnancy along with their birth weight are both used on a graph to determine whether a baby is

AGA which means appropriate for gestational age, LGA which is large for gestational age or SGA small for

gestational age. So, an infant's weight, a newborn's weight at birth in and of itself doesn't

determine whether they're a big baby or a small baby or an average baby. Um, it's their weight along with how far

along they were in the pregnancy determines their size. And this is a cross-section of a

non-gravid and a gravid woman. So, gravid meaning pregnant, non-pregant or pregnant um at about full term. And this

I think is just a really good representation of all of the changes that take place um

just anatomically during a pregnancy. So, as we move through this course and talk about um pregnancy and labor and

delivery and postpartum and all of those changes that occur throughout that time period, um if you ever need to refer

back to this to kind of put some context to what we're talking about in learning, I think this gives a really great visual

representation of all the changes that take place and cause a lot of the signs and

symptoms that we see or hear during pregnancy. And that's it. That's your first mini

lecture. I will meet each of you in class. And I hope this helps get you started off on the right foot.