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GTPAL

Pregnancy Outcomes Acronym

Authors:Nikol Natalia Armata,Alyssa Haag

Editors:Józia McGowan, DO,Kelsey LaFayette, DNP, RN

Illustrator:Jessica Reynolds, MS

Copyeditor:Stacy M. Johnson, LMSW


What is GTPAL?

GTPAL is an acronym to remember essential information for a complete obstetric history. Each letter represents one aspect of the obstetric history that should be assessed when examining an individual for the first time, including gravidity, term, preterm, abortion, and living. 

Sometimes not all information about the individual's pregnancy history is provided in detail. For example, an individual described as 'gravida 2, para 2' (sometimes abbreviated to G2 P2) has had two pregnancies and two deliveries after 20 weeks. In contrast, an individual described as 'gravida 2, para 1' (G2 P1) has had two pregnancies or is still currently pregnant, but only one survived to a gestational age of 20 weeks or more. Therefore, the abbreviation gravida and para are frequently used, providing the number of pregnancies and deliveries after 20 weeks.

Illustration of a clinician and pregnant female discussing her GTPAL outcomes in a word bubble.

Why is GTPAL important?

GTPAL is very important at the initial assessment to ensure the healthcare professional has asked for all the crucial information about an individual’s reproductive history. It also provides a great deal of knowledge of the individual’s potential complications at a glance, like lost pregnancies or preterm births, and ensures a better healthcare plan.  

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How is GTPAL calculated?

Healthcare providers calculate GTPAL (e.g., OBGYN, medical, or nursing student) using the initial obstetric history of an individual. Each letter is calculated separately. For example, ‘G4 T2 P1 A1 L3’ describes an individual who has had four pregnancies, two of which had passed 37 weeks of gestation, one was preterm, and one was lost before 20 weeks of gestation.  This individual has three living children. 

What does the “G” in GTPAL mean?

The G in GTPAL stands for gravida. This is the number of times an individual has conceived, including any current pregnancy. More specifically, it includes the total number of pregnancies, not deliveries, no matter the gestational age or outcome of the pregnancy. 

What does the “T” in GTPAL mean?

The T in GTPAL stands for term births. This refers to the number of times an individual has carried a pregnancy to at least 37 weeks of gestation and delivered. 

What does the “P” in GTPAL mean?

The P in GTPAL stands for preterm deliveries. Babies born between 20 and 36 weeks 6/7 days of gestation are all included in this section. This is important to differentiate that this P is different from parity. Parity would consist of any delivery after 20 weeks of gestation, regardless of whether the child was born alive or stillborn, and any deliveries after 36 weeks.

What does the “A” in GTPAL mean?

The A in GTPAL stands for the number of abortions. This refers to all times the individual has lost a pregnancy whether elective (i.e., medical or surgical) or spontaneous (i.e., miscarriage, ectopic pregnancies) before 20 weeks. For example, termination of pregnancy at six weeks and an unexpected stop of a fetal heartbeat at 12 weeks are both calculated as abortions. 

What does the “L” in GTPAL mean?

The L in GTPAL stands for the number of living children but refers to the number of live births an individual has had. Each living child is counted individually. So if there has been a pregnancy of twins, that would be calculated as G1 because it's one pregnancy, but L2 as there are two living children. 

What are the most important facts to know about GTPAL?

GTPAL is an acronym used to remember the critical information that should be asked about an individual’s reproductive history. GTPAL stands for gravidity (i.e., number of pregnancies including current); term (i.e., number of pregnancies carried to 37+ weeks); preterm (i.e., number of pregnancies carried between 20 and 36 6/7 weeks); abortion (i.e., number of losses before 20 weeks); and living (i.e., number of living children). 

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Related links

Pregnancy
Miscarriage
Preterm labor

Resources for research and reference

Beebe, K. R. (2005). The perplexing parity puzzle. AWHONN Lifelines, 9(5), 394–399. https://doi.org/10.1177/1091592305283142  

Tidy, D. C. (2019, January 21). Gravidity and parity definitions (implications in risk assessment). Patient.info. Retrieved April 14, 2022, from https://patient.info/doctor/gravidity-and-parity-definitions-and-their-implications-in-risk-assessment