Obstetric Classification: Nullipara
A woman who is currently pregnant and has had 2 previous miscarriages is classified as nullipara (Option C).
Understanding Obstetric Terminology
The key to answering this question lies in understanding the distinction between gravidity and parity:
Gravidity Classification
- Gravida refers to the total number of pregnancies a woman has had, including the current one 1
- This woman is in her third pregnancy (2 previous miscarriages + 1 current pregnancy), making her a multigravida, not a primigravida 1
- Primigravida specifically means a woman pregnant for the first time 2, 3
- Nulligravida means a woman who has never been pregnant 1
Parity Classification
- Para refers only to pregnancies that reached viability (typically ≥20 weeks gestation) and resulted in delivery, regardless of whether the infant was born alive 1, 4
- Miscarriages (spontaneous abortions occurring before 20 weeks) do not count toward parity 4, 5
- Nullipara means a woman who has never given birth to a viable infant 1
- Multipara means a woman who has given birth two or more times at viable gestational age 1
Why This Patient is Nullipara
- Since both previous pregnancies ended in miscarriage (before viability), they do not contribute to her parity count 4, 5
- She has never delivered a pregnancy that reached viability, making her nullipara despite being in her third pregnancy 1
- Her current pregnancy status does not change her parity classification until she delivers 1
Clinical Significance
- Nulliparous women are considered higher risk for operative interventions including cesarean section and instrumental delivery 3, 6
- History of recurrent miscarriage (≥2 losses) warrants evaluation for underlying causes such as antiphospholipid syndrome 4
- Primiparity (first birth) carries increased risks for prolonged labor, fetal distress, and operative delivery compared to multiparity 6