Gestosis Score in Antenatal Care: A Practical Approach to Pre-eclampsia Risk Assessment

Background Gestosis score is a first-trimester screening tool developed by the Federation of Obstetric and Gynaecological Societies of India (FOGSI). This study aimed to evaluate the predictive accuracy of the gestosis score for identifying pregnant women at high risk of developing pre-eclampsia (PE) and associated adverse maternal and perinatal outcomes. Methods A prospective observational cohort study was conducted involving 130 pregnant women between nine and 12 weeks of gestation at a tertiary care hospital in Chennai, India. Participants were stratified into high-risk (GS ≥3) and low-risk (GS <3) groups based on clinical parameters, including BMI, mean arterial pressure, history of chronic hypertension, and use of assisted reproductive technology. Maternal and fetal outcomes were monitored until delivery. Results Of the 130 women, 39 (30%) had a GS ≥3, among whom 12 (30.7%) developed PE, compared to only 4 (4.4%) in the low-risk group (p<0.001). High GS was significantly associated with early-onset PE, intrauterine growth restriction, oligohydramnios, preterm delivery, lower gestational age at birth (36.4 vs. 38.2 weeks, p<0.001), reduced birth weight (2380 g vs. 2900 g, p<0.001), and higher rates of cesarean section and neonatal intensive care unit (NICU) admissions. Maternal age, obesity, anemia, chronic hypertension, and autoimmune disorders were strongly correlated with high GS. GS ≥3 demonstrated a sensitivity of 75% and a specificity of 76.3% for predicting PE. Conclusion GS is an effective, low-cost, and easily applicable tool for early identification of women at high risk for PE and related complications in resource-limited settings. Its integration into routine antenatal care may facilitate timely interventions and improve maternal and perinatal outcomes. Further multicenter studies are recommended to validate these findings and support broader adoption in national guidelines.