Publication:

Comparison of gestosis score vs uterine artery pulsatility index in predicting hypertensive disorders of pregnancy: a prospective observational study

Background Hypertensive disorders of pregnancy include conditions such as gestational hypertension, pre-eclampsia, and severe pre-eclampsia. Early prediction and management of these hypertensive disorders are therefore essential to improve health outcomes and reduce pregnancy-related complications. This study aims to compare the predictive performance of the gestosis score and uterine artery pulsatility index for hypertensive disorder of pregnancy, and to evaluate the individual effectiveness of each tool in predicting the severity of these disorders.

Methods This prospective observational study included 140 pregnant women at 11 to 14 weeks. Participants were stratified into risk groups based on their gestosis score. The uterine artery PI was measured using doppler ultrasound and mean uterine artery PI>95th percentile was classified as high risk. Participants were followed up till delivery to record the occurrence of hypertensive disorders of pregnancy.

Results Hypertensive disorders of pregnancy affected 34% of participants, with gestational hypertension in 16.4%, preeclampsia in 15.7%, and severe preeclampsia in 2.1%. The gestosis score classified 67.2% study participants as high risk, while uterine artery PI>95th percentile was noted in 37.1% pregnant women. The gestosis score demonstrated a sensitivity of 85.4% and specificity of 75.0% for hypertensive disorders of pregnancy (AUC 0.855), with 91.3% sensitivity for gestational hypertension and 77.2% sensitivity for preeclampsia, and 100% for severe preeclampsia. Uterine artery PI showed a sensitivity of 77.1% and specificity of 83.7% for hypertensive disorders of pregnancy (AUC 0.765), with 91.3% sensitivity for gestational hypertension, 63.6% for preeclampsia, and 66.7% for severe preeclampsia.

Conclusions The gestosis score, owing to its high sensitivity is a valuable screening tool for HDOP in resource-limited settings. In contrast, UtA-PI offers superior diagnostic accuracy with balanced sensitivity and specificity, making it an effective non-invasive Doppler marker.