Publication:

An observational study to determine the efficacy of FOGSI gestosis score as a predictor of pre-eclampsia and Ecosprin prophylaxis as a preventive intervention

Background FOGSI gestosis score is a simple risk model devised for preeclampsia screening and prediction. Each risk factor is given score of 1, 2 or 3 based on severity. A total score of ≥3, implies ‘at risk’ for developing preeclampsia warranting closer monitoring and management. Also, Ecosprin prophylaxis in these high-risk pregnancies can reduce the incidence of early onset preeclampsia as well as maternal and neonatal morbidity and mortality.

Methods This prospective OBSERVATIONAL study was conducted at GMC Amritsar, involving 100 pregnant women at ≤24 weeks of gestation (Group A), screened using gestosis score. Participants identified as high-risk (score ≥3) received prophylactic Ecosprin and monitored until 6 weeks postpartum for maternal and neonatal outcomes which were compared with 145 unbooked, already known cases of preeclampsia/eclampsia (group B).

Results Among 100 participants screened as per gestosis score, 29% were high risk and 71% low risk. Preeclampsia developed in 31% of high-risk versus 4.2% of low-risk participants (IRR=8.98, p=0.0002). Significant predictors included anaemia, primigravida status, BMI>30 and MAP>85 mmHg. Preterm birth, FGR, unfavourable APGAR score and perinatal mortality were more common in the high-risk group. The score demonstrated 82.35% sensitivity, 82.69% specificity, 43.75% PPV, 96.63% NPV, and 82.64% accuracy in predicting Preeclampsia, indicating good screening potential.

Conclusions Gestosis score is low cost, noninvasive screening tool for predicting preeclampsia and adverse pregnancy outcomes, particularly in resource-constrained settings. Early Ecosprin prophylaxis significantly reduces the incidence and severity of complications in high-risk pregnancies.