Overview
This lecture covers the GPTPAL obstetrical scoring system, its key definitions, application through clinical scenarios, and associated terminology in obstetrics.
GPTPAL Mnemonic Overview
- GPTPAL is used for recording a woman’s obstetrical history: Gravida, Para, Term, Preterm, Abortion, Living, and Multiple pregnancies.
- G: Gravida — total number of pregnancies (past and present), including current, twins, and abnormal pregnancies.
- P: Para — number of births at or beyond the age of viability (≥20 weeks gestation).
- T: Term — number of deliveries between 37 and 42 weeks gestation.
- P (again): Preterm — number of deliveries from 20 to 36.5 weeks gestation.
- A: Abortion — number of pregnancies ending before 20 weeks (includes miscarriages).
- L: Living — number of children currently alive.
- M: Multiple pregnancy — counts multiple gestation births as one pregnancy/delivery.
Application of GPTPAL Scoring
- Multiple births (twins, triplets) count as one gravida and one para if delivered in the same pregnancy.
- Example calculation: Woman currently pregnant (1 G), had twins at 32 weeks (1 P), and a miscarriage at 8 weeks (1 A) = G3 P1 A1.
- Living children equal the total number of children alive, not pregnancies.
- Clinical scenarios illustrate how to tabulate GPTPAL scores correctly based on information given.
Key Terms & Definitions
- Gravida — Total number of pregnancies, regardless of outcome.
- Nulligravida — Never been pregnant.
- Primigravida — Pregnant for the first time.
- Multigravida — Pregnant two or more times.
- Para (Parity) — Number of pregnancies carried beyond 20 weeks.
- Nullipara — No pregnancies beyond 20 weeks.
- Primipara — One pregnancy beyond 20 weeks.
- Multipara — Two or more pregnancies beyond 20 weeks.
- Grand multipara — Five or more pregnancies past 20 weeks.
- Term — Delivery between 37–42 weeks gestation.
- Preterm — Delivery between 20–36.5 weeks gestation.
- Abortion — Pregnancy loss before 20 weeks gestation.
- Living — Number of living children.
Action Items / Next Steps
- Practice computing GPTPAL scores using sample clinical cases.
- Review and memorize key obstetric definitions and the GPTPAL mnemonic.