The advanced practice registered nurse (APRN) is seeing a pregnant patient at 30 weeks gestation. The patient has had 4 total pregnancies including the present pregnancy and 3 first trimester spontaneous abortions (miscarriages before 24 weeks gestation). How would the APRN document the gravida (G) and para (P)?

Gravida (G) and para (P) classification summarizes a patient’s total pregnancy history and outcomes. Gravida includes all pregnancies, regardless of outcome or gestational age. Para includes pregnancies that reach viability (generally ≥20–24 weeks), regardless of fetal outcome. Miscarriages occurring before viability are not counted in parity. Rationale: A. G4P3 is incorrect because it overestimates parity. The patient has had three first-trimester spontaneous abortions, which do not reach fetal viability and therefore do not contribute to para. Only pregnancies reaching viability are counted in the P component, making this option inconsistent with obstetric standards. B. G3P3 is incorrect because it undercounts total pregnancies. The patient is currently pregnant (1) plus three prior pregnancies, making the total gravida four. This option fails to include the current pregnancy, leading to inaccurate obstetric history documentation. C. Gravida and Para classification correctly documents the patient as G4P0 because she has had four total pregnancies (including the current one) and no pregnancies reaching viability beyond 20–24 weeks. All prior pregnancies ended in first-trimester miscarriage, which are not counted in parity. This accurately reflects both total pregnancy count and viable pregnancy outcomes. D. G4P1 is incorrect because it incorrectly indicates one viable pregnancy. The patient has had no pregnancies reaching fetal viability, as all prior losses occurred in the first trimester. Therefore, parity should remain zero.