DETERMINING GRAVIDITY

AND PARITY
A gravida is a pregnant woman.

A nulligravida or gravida 0 is a
woman who has never been
pregnant.
A primigravida or gravida 1 is a
woman who is pregnant for the first
time or has been pregnant one time.
A multigravida or more specifically
a gravida2 
(also secundigravida), gravida 3, and so
on, is a woman who has been pregnant
more than one time.
An elderly primigravida is a woman in her
first pregnancy, who is at least 35 years old.
This term is becoming less common as it
may be considered offensive.
The term gravida is generally coupled
with para (and occasionally additional
terms) to indicate more details of the
woman's obstetric history.
A woman who has never given birth is
a nullipara, a nullip, or para 0.
A woman who has never completed a
pregnancy beyond 20 weeks is also referred to
as being nulliparous, a nullipara or para 0.
A woman who has given birth one or more
times is referred to as para 1,
para 2, para 3 and so on.
A woman in her first pregnancy and
who has therefore not yet given birth
is a nullipara . After she gives birth
she becomes a primipara
A woman who has given birth once
before is primiparous, and would be
referred to as a primipara 
A woman who has given birth
two or more times is multiparous 

Grand multipara refers to a
(grand multiparous) woman who
has given birth five or more
times.
Gravida indicates the number of
times the mother has been
pregnant, regardless of whether
these pregnancies were carried to
term.
A current pregnancy, if any, is
included in this count.
Para indicates the number of
>20 wks births (including viable and
non-viable i.e. stillbirths).
Pregnancies consisting of multiples,
such as twins or triplets, count as ONE
birth for the purpose of this notation.
Abortus is the number of
pregnancies that were lost for any
reason, including induced
abortions or miscarriages. The
abortus term is sometimes
dropped when no pregnancies
have been lost. Stillbirths are not
included.
TPAL is one of the methods to
provide a quick overview of a
female's obstetric history. Two
other methods often used
are gravida/para and GPA.
In TPAL, the T refers to term births (after
37 weeks gestation), the P refers
to premature births, the A refers
to abortions, and the L refers to living
children. The TPAL is described by
numbers separated by hyphens. Multiple
births (twins, triplets and higher multiples)
count as one birth, but each living child is
counted separately.
Term – refers to 37 completed weeks’
gestation and beyond
Preterm – born between 20 – 37 weeks
Abortion – number of pregnancies
terminated before the age of viability or
before 20 weeks
Living – currently living children
For example, a pregnant woman who
carried one pregnancy to term with a
surviving infant; carried one pregnancy to
35 weeks with surviving twins; carried one
pregnancy to 9 weeks as an ectopic (tubal)
pregnancy; and has 3 living children would
have a TPAL annotation of T1, P1, A1, L3.
This could also be written as 1-1-1-3.
Note, the "abortions" number refers to
the total number of
induced abortions and
miscarriages or ectopic pregnancies prior
to 20 wks. If a fetus is aborted after 20
wks, spontaneously or electively, then it is
counted as a premature birth and P will
increase but L will not.
Exercise A:

Mrs. Chan, 22-year-old, 4 month

pregnant consulted your clinic.
Exercise #1:
Her OB history are as follows: first
pregnancy at age 15, complicated with
pregnancy-induced-hypertension, ended
in the birth of a SGA; second pregnancy
at age 18 resulted in the birth of twins, a
boy and a girl; a third pregnancy at age
20 ended in the birth of a stillbirth with
gestational age of 35 weeks.
Lets Analyze…..
 Gravida - 4
first pregnancy at age 15
second pregnancy at age 18
third pregnancy at age 20
4 month pregnant (at present
 Term - 2
first pregnancy at age 15, complicated
with pregnancy-induced-hypertension,
ended in the birth of a SGA; second
pregnancy at age 18 resulted in the birth
of twins, a boy and a girl; a third
pregnancy at age 20 ended in the birth of
a stillbirth with gestational age of 35
weeks.
Preterm - 1
first pregnancy at age 15, complicated
with pregnancy-induced-hypertension,
ended in the birth of a SGA; second
pregnancy at age 18 resulted in the birth
of twins, a boy and a girl; a third
pregnancy at age 20 ended in the birth of
a stillbirth with gestational age of 35
weeks.
Abortion - 0
first pregnancy at age 15, complicated
with pregnancy-induced-hypertension,
ended in the birth of a SGA; second
pregnancy at age 18 resulted in the birth
of twins, a boy and a girl; a third
pregnancy at age 20 ended in the birth of
a stillbirth with gestational age of 35
weeks.
Living - 3
first pregnancy at age 15, complicated
with pregnancy-induced-hypertension,
ended in the birth of a SGA; second
pregnancy at age 18 resulted in the birth
of twins, a boy and a girl; a third
pregnancy at age 20 ended in the birth of
a stillbirth with gestational age of 35
weeks.
 She is G4P3

G–T–P–A– L
Score
4–2 –1–0–3
Exercise #2:

What does the five-digit system

obstetrical score of 7–4–1 –
1 – 4 mean?