Describing pregnancy

[waterski232002]

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How do you describe the number of pregnancies an obstetric patient has had...

G, P, A... G, P, X-X-X-X... etc...

 

[lucky_deadman]

How do you describe the number of pregnancies an obstetric patient has had...

G, P, A... G, P, X-X-X-X... etc...

Depends on whom the audience is. Ob/Gyns like the Gx P(tpal) thing; whereas most of the rest of us are probably fine with total Gs and Ps.

 

[Apollyon]

G - gravidity - pregnancies
P - parity - births
0 - term
0 - preterm
0 - mis/abort
0 - alive at one year

Currently pregnant, 3 term, one preterm, one miscarriage, children alive at one year would be G6 P3114.

 

[Jeff698]

Just the Gs and Ps for me.

Take care,
Jeff

 

[Apollyon]

Just the Gs and Ps for me.

Take care,
Jeff

But don't you use IBEX? That asks for G/P/A.

 

[basementbeast]

G - gravidity - pregnancies
P - parity - births
0 - term
0 - preterm
0 - mis/abort
0 - alive at one year

Currently pregnant, 3 term, one preterm, one miscarriage, children alive at one year would be G6 P3114.

Florida Power And Light => FPAL

F = Full Term
P = Preterm
A = Abortion
L = Living

 

[DrQuinn]

I generally just use G/P. For the past few weeks I've been doing the FPAL thingy, but yesterday had a doozy, she was pregnant 6 times, had 4 live births, one was twin, one was a still born.... so, I ended up just writing G6P4, even though it would only have taken about 20 seconds to figure out, I got bore quickly.

I've been havin gto write a lot of "not on IVF" on my charts because I've caught three heterotopics in the past year.

Q

 

[Jeff698]

But don't you use IBEX?

Sort of. We use IBEX as our 'white board' to sign up for patients and order labs. We use a templated paper chart, SmartNotes, for our documentation.

I'll occasionally use the IBEX documentation for a procedure note or for a hand-off note.

Take care,
Jeff

 

[Jeff698]

I've been havin gto write a lot of "not on IVF" on my charts because I've caught three heterotopics in the past year.

Now that's scarry. Please tell me all three had IVF?

The last thing I need is to see a happy IUP and start second guessing myself on every non-IVF patient out there.

Take care,
Jeff

 

[docB]

Now that's scarry. Please tell me all three had IVF?

The last thing I need is to see a happy IUP and start second guessing myself on every non-IVF patient out there.

Take care,
Jeff

I've often wondered about this problem. We are continually being told that heterotopics are increasing in frequency but what can we do about it? US is often nondiagnostic and we can't send every 1st teimester pelvic pain WITH and IUP to the OR for a scope (that would be ~20/day at my house). So what do you do with them? Is anyone going to "the next step" once you find the IUP? What is the next step?

 

[Hard24Get]

Now that's scarry. Please tell me all three had IVF?

The last thing I need is to see a happy IUP and start second guessing myself on every non-IVF patient out there.

Take care,
Jeff

what a yucky thought - I had 6 P&Bs last night, all with early or aborting IUPs!

 

[Jeff698]

So what do you do with them? Is anyone going to "the next step" once you find the IUP? What is the next step?

I'm still calling 'done' once I find an IUP in a non-IVF patient. I'm just likely to be a little more worried about it now. Hopefully Quinn will reassure me that all those heterotropics were IVFers.

As you pointed out, this population of patients makes up a huge part of our daily census. Our OB folks (who handle a bunch of primary care crap >20 weeks that would otherwise come to us) would drown if we sent them all of our IUPs to exclude heterotropics. We don't have much of a choice but to say we're done after finding the IUP and give them good instructions.

Take care,
Jeff

 

[TeaNCrackers]

I had to register just because of this thread.

I had a hetertopic pregnancy in 2005. I did not get pregnant through IVF. We were on Clomid, though.

The pregnancy had a strange start. When I had my blood test to determine if I had ovulated, I had, but the level was very low, so we thought that pregnancy was not attainable that cycle. Then, I missed my period. When the OB sent me for blood work, my beta levels were very low. So we repeated them. They were still low but they were climbing, so we assumed that all was well.

I had continual spotting throughout the first 12 weeks and even visited the ER one weekend due to lots of spotting. The lab at the ER told me my beta level was non-existant and that I was miscarrying. They sent me home and then called the next day that they were wrong and all was well and the number was considerably higher than the last that I had received.

When we talked to the OB, he said that the numbers appeared that I might be carrying twins, but ultrasound only showed one heartbeat in the uterus.

At 12 weeks exactly, the ectopic pregnany ruptured and I had emergency surgery with over a liter of blood taken from my abdomen. All was well after that and my little guy just turned two last month (He's crackers).

Not sure how that is all relevant, but I just had to thow it out there.

 

[basementbeast]

being on clomid is relevant...

 

[DrQuinn]

Nope. None of my heteros were on IVF. I had two in residency and then one about 4 months ago. I don't remember the ones in residency (We didn't do our own u/s, we sent them for a formal u/s), but the one I had this year as an attending was a walkie talkie, I think she had hx of PID in the past. I saw a yolk sac but nothing much, and a little mass on the side, I just had OB come down to see her, and they confirmed it.

That being said, if I see an IUP with nice heart tones, I'll boot 'em out the door, unless of course they're IVF or on clomid. Granted I will make sure to document "close follow up with your OB" and to return if worse in anyway.

Q