Never given birth is the term used in a woman who has never carried a pregnancy beyond 20 weeks Those women are nulliparous, and is called a nullipara or para 0. 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 woman in her first pregnancy, who is at least 35 years old. Never giving birth during lifetime is associated with exposing to high levels of hormones for longer periods of time that increases the risk cancers of reproductive organs. Types of childlessness can be classified into several categories: Natural sterility Natural sterility randomly affects individuals. One can think of it as the minimum level of permanent childlessness that we can observe in any given society, and is of the order of 2 percent. Social sterility Social sterility which one can also call poverty driven childlessness, or endogenous sterility (sterility by manipulating endogenous hormone levels), describes the situation of poor women whose fecundity has been affected by poor living conditions. People who are childless by circumstance. These people can be childless because they have not met a partner with whom they would like to have children, or because they tried unsuccessfully to conceive at an advanced maternal age, or because they suffer from certain medical issues, such as endometriosis or polycystic ovary syndrome (PCOS), that make it difficult for them to conceive. People who are childless by choice Many of these are educated and tend to postpone marriage to invest more in their career, or have a very high opportunity cost to bear and rear a child, often in terms of foregone labour income. The first three categories are often grouped under the label "involuntary childlessness". The latter category is often called "voluntary childlessness", also described as being "childfree", occurring when one decides not to reproduce. Medical interventions may be available to some individuals or couples to treat involuntary childlessness. Some options include artificial insemination, intracytoplasmic sperm injection (ICIS) and in vitro fertilization (IVF). For those facing social infertility (such as single individuals or same-sex couples) as well as heterosexual couples with medical infertility, other options include surrogacy and adoption. Surrogacy, in this case a surrogate mother, is the process in which a woman becomes pregnant (usually by artificial insemination or surgical implantation of a fertilized egg) for the purpose of carrying the fetus to term for another individual or couple. Another option may be adoption; to adopt is to take voluntarily (a child of other parents) as one's own child. Symptoms Prolonged nulliparity Delaying the first childbirth to an advanced age has increased significantly during the last decades. Pregnancy at advanced maternal age, defined as age 35 years or older, is associated with several adverse pregnancy outcomes including preterm birth, low birth weight, still birth, chromosomal defects, labor complications, and cesarean section; therefore, it is considered to be a “high risk” pregnancy. Associated diseases
Complications An increased risk cancer of reproductive organs has been found due to nulliparity. In most studies, the risk of uterine cancer decreases with increasing parity, especially among women in reproductive years. Several recent studies have shown that past births at the end of reproductive life may reduce the risk of uterine cancer. A uterine cancer is associated with prolonged exposure to estrogen (female sex hormone) and pregnancy provides a period of endometrial “rest”. Also the women who take birth control pills for at least five years during her reproductive years are at reduced likelihood of developing the disease. Women who have also been to get pregnant are at lower risk of getting ovarian cancer than women who have never given birth. Prolonged nulliparity is a risk factor for breast cancer. Pregnancy may reduce breast cancer risk through induction of persistent changes of the mammary gland that make the breast less susceptible to carcinogenic factors. Risk factors
Prevention The only possible prevention of nulliparity is to become pregnant. On the other side, oral contraceptives have been shown to reduce the risk for ovarian cancer but it could increase the risk of breast cancer.
a. Gravida. A pregnant woman. This refers to any pregnancy regardless of duration. b. Para. A woman who has delivered a viable young (not necessarily living at birth). Para is used with numerals to designate the number of pregnancies that have resulted in the birth of a viable offspring (see para 3-3). c. Nulligravida. A woman who has never been pregnant. d. Nullipara. A woman who has not delivered a child who reached viability. e. Primigravida. A woman pregnant for the first time. f. Primipara. A woman who has delivered one child after the age of viability. g. Multigravida. A woman who has been pregnant more than once. h. Multipara. A woman who has delivered two or more fetuses past the age of viability. It does not matter whether they are born dead or alive. i. Grandmultipara. A woman who has had six or more births past the age of viability. j. Viability. Refers to the capability of a fetus to survive outside the uterus after the earliest gestational age (approximately 22 to 23 weeks gestation). k. In utero. Refers to within the uterus. In biology and human medicine, gravidity and parity are the number of times a woman is or has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity).[1] These terms are usually coupled, sometimes with additional terms, to indicate more details of the woman's obstetric history.[2] When using these terms:
In human medicine, "gravidity" refers to the number of times a woman has been pregnant,[1] regardless of whether the pregnancies were interrupted or resulted in a live birth:
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 woman in their first pregnancy who is at least 35 years old.[4] Advanced maternal age can be a risk factor for some birth defects.
In biology, the term "gravid" (Latin: gravidus "burdened, heavy"[5]) 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.
In human medicine, parity is the number of pregnancies carried by a woman for at least 20 weeks (duration varies from region to region, 20 – 28 weeks, depending upon age of viability). If a woman 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.[6][7] A woman who has never carried a pregnancy beyond 20 weeks is nulliparous and is called a nullipara or para 0.[8] A woman who has given birth once is primiparous and is referred to as a primipara or primip. A woman 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.[9] Like gravidity, parity may also be counted. A woman 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.
In agriculture, parity 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".[10][11] 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.
NulliparityA nulliparous (/nʌlˈɪpərəs/) woman (a nullipara or para 0) has never given birth. It includes women who have experienced spontaneous miscarriages and induced abortions before the mid-point of pregnancy, but not women who have experienced pregnancy loss after 20 weeks. Long-term and permanent nulliparity (/ˌnʌlɪˈpærɪti/) are risk factors for breast cancer. For instance, a meta-analysis 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 women who have given birth, and for every 2 births, the risk was reduced by about 16%. Women 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.[12] A number of systems are incorporated into a woman'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.[16] In obstetrics, the term can lead to some ambiguity for events occurring between 20 and 24 weeks,[17] and for multiple pregnancies.[18]
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