G4P3L2D1
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obstetric history notation GTPAL gravida para explained
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G4P3L2D1 is an obstetric history notation using the GTPAL (or GPAL) system, which systematically summarizes a woman's pregnancy history.
Breaking Down G4P3L2D1
| Symbol | Term | Value | Meaning |
|---|---|---|---|
| G4 | Gravida | 4 | Has been pregnant 4 times (including the current pregnancy, if present) |
| P3 | Para | 3 | Has delivered 3 pregnancies at ≥20 weeks gestation (regardless of outcome) |
| L2 | Living | 2 | Has 2 living children |
| D1 | Dead / Deceased | 1 | 1 child born alive but subsequently died |
Key Points
- Gravida (G) counts every pregnancy, including the current one, miscarriages, ectopic pregnancies, and terminations.
- Para (P) counts deliveries ≥20 weeks, not the number of infants. A twin delivery = Para 1 (one delivery event).
- Living (L) refers to children alive at the time of the history — not at birth.
- Dead (D) refers to children born alive who later died (neonatal or childhood death), not stillbirths.
Reconstructing This Patient's History
From G4P3L2D1:
- 4 total pregnancies, 3 resulted in delivery ≥20 weeks
- 1 pregnancy did not reach viability (likely 1 miscarriage, ectopic, or termination: G4 − P3 = 1 undelivered pregnancy)
- Of the 3 delivered children: 2 are living, 1 has died after birth
- Stillbirths would be captured in the para count but would not contribute to L or D
Extended GTPAL Notation (if more detail is needed)
Some institutions use the full GTPAL system:
| G | T | P | A | L |
|---|---|---|---|---|
| Gravida | Term births (≥37 wks) | Preterm births (20–36 wks) | Abortions/losses <20 wks | Living children |
The notation you provided uses a slightly different convention (GPLD), which is common in many clinical settings alongside or instead of GTPAL.
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