Gravida 4, para 2 means that the patient has had four pregnancies and given birth twice during those pregnancies. The number of children per pregnancy is not reflected in this information. If the patient is gravida 4 then she could only be pregnant for the fourth time. Parity of 2 could be a birth with a single child and birth with twins, making it possible the patient has delivered three children. If the parity is less than the gravidity then it is possible the patient was pregnant but had an elective abortion and there is nothing to exclude the possibility of triplets.