Hypertensive disorders in pregnancy gestosis score as a predictor of pre-eclampsia

Authors

  • Dhivya B. Department of Obstetrics and Gynaecology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
  • Revwathy Kailairajan Department of Obstetrics and Gynaecology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
  • Dhivya Sethuraman Department of Obstetrics and Gynaecology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253072

Keywords:

Hypertensive disorders in pregnancy, HDP gestosis score, Pre-eclampsia, Prediction, Risk factors

Abstract

Background: Pre-eclampsia (PE) significantly contributes to maternal and neonatal morbidity, particularly in low-resource settings. The hypertensive disorders in pregnancy (HDP) gestosis score integrates clinical risk factors to identify women at risk. This study aimed to assess the ability of the HDP gestosis score to predict PE, analyse associated risk factors, and highlight the importance of early risk stratification in primary care.

Methods: This analytical/observational prospective study was conducted on 280 patients at SRM Medical College Hospital, Trichy, between June 2024 and March 2025. Baseline data, including demographics, obstetric history, and medical conditions, were collected from records and interviews during the first visit. The HDP scoring system was applied, and all participants were prospectively followed up until delivery.

Results: Among 280 mothers, 46 (16.4%) developed PE. Mothers with PE had a significantly higher mean age (29.7±6.1 years) than those without PE (p<0.001). Obesity (p<0.001), age >35 years (p<0.001), ART use (p<0.001), hypothyroidism (p<0.001), and chronic hypertension (HTN) (p<0.001) were significantly associated. A Gestosis score ≥3 was present in 17.5% of mothers, with 71.7% of them developing PE (p<0.001). The score showed a sensitivity of 71.7%, specificity of 93.2%, negative predictive value of 94.4%, positive predictive value of 67.4%, and an accuracy of 89.7%, confirming its value for early risk stratification and PE prediction in primary care.

Conclusions: PE was associated with advanced age, obesity, ART use, hypothyroidism, family history, multiple pregnancies, diabetes, and HTN. An HDP Gestosis score ≥3 predicted PE with high specificity and moderate sensitivity, supporting its use in antenatal risk assessment.

Metrics

Metrics Loading ...

References

Yang Y, Le Ray I, Zhu J, Zhang J, Hua J, Reilly M. Pre-eclampsia prevalence, risk factors, and pregnancy outcomes in Sweden and China. JAMA Netw Open. 2021;4:e218401. DOI: https://doi.org/10.1001/jamanetworkopen.2021.8401

Mou AD, Barman Z, Hasan M, Miah R, Hafsa JM, Das TA, et al. Prevalence of pre-eclampsia and the associated risk factors among pregnant women in Bangladesh. Sci Rep. 2021;11:21339. DOI: https://doi.org/10.1038/s41598-021-00839-w

Dhinwa M, Gawande K, Jha N, Anjali M, Bhadoria AS, Sinha S. Prevalence of hypertensive disorders of pregnancy in India: a systematic review and meta-analysis. J Med Evid. 2021;2:105-12. DOI: https://doi.org/10.4103/JME.JME_168_20

Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15:275–89. DOI: https://doi.org/10.1038/s41581-019-0119-6

Gavali S, Patil A, Gavali U. Study of fetomaternal outcome in patients with pregnancy induced hypertension at Sangli district. MedPulse Int J Gynaecol. 2021;20:65–9. DOI: https://doi.org/10.26611/10122025

Satish S, Suma KB, Madhu, Sujatha. Maternal pregnancy associated plasma protein-A (PAPP-A) and uterine artery Doppler changes as predictors of pre-eclampsia: a prospective observational study from a teaching hospital in Mysore, Karnataka, India. Int J Reprod Contracept Obstet Gynecol. 2019;8:1317. DOI: https://doi.org/10.18203/2320-1770.ijrcog20190977

Mao J, Sun H, Shen Q, Zou C, Yang Y, Du Q. Impact of pre-pregnancy body mass index on pre-eclampsia. Front Med (Lausanne). 2025;12:1529966. DOI: https://doi.org/10.3389/fmed.2025.1529966

Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019;1451:1–33. DOI: https://doi.org/10.1002/ijgo.12802

Poon LC, Nicolaides KH. Early prediction of pre-eclampsia. Obstet Gynecol Int. 2014;2014:297397. DOI: https://doi.org/10.1155/2014/297397

Verma S, Verma P, Dwivedi S, Gupta R, Gupta N, Agrawal S, Yadav R. Gestosis score: a non-invasive tool for the prediction of pre-eclampsia. J Contemp Clin Pract. 2024;10(2):219–26.

Gupta M, Yadav P, Yaqoob F. A prospective study to determine the predictive ability of HDP-gestosis score for the development of pre-eclampsia. J Obstet Gynaecol India. 2022;72:485–91. DOI: https://doi.org/10.1007/s13224-022-01704-0

Imam ST. Improvement in the cases of hypertensive disorder of pregnancy with help of HDP-gestosis score. Int J Reprod Contracept Obstet Gynecol. 2023;12:671–4. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230536

Upadhyay A, Chaurasia A. Prediction of pre-eclampsia by HDP gestosis score. Int J Reprod Contracept Obstet Gynecol. 2024;13:1726–30. DOI: https://doi.org/10.18203/2320-1770.ijrcog20241766

Reddy P, Indrani C, Vydyanath V. A prospective study to determine the predictive ability of hypertensive disorders during pregnancy-gestosis score for the development of pre-eclampsia. Int J Reprod Contracept Obstet Gynecol. 2024;13(11):3066-70. DOI: https://doi.org/10.18203/2320-1770.ijrcog20242989

Jaiswal J, Shrivastava A, Keshkar M. Correlation of hypertensive disorder of pregnancy gestosis score with severity of hypertensive disorder of pregnancy. Int J Reprod Contracept Obstet Gynecol. 2025;14(2):431-7. DOI: https://doi.org/10.18203/2320-1770.ijrcog20250006

Nyfløt LT, Stray-Pedersen B, Forsén L, Vangen S. Duration of labor and the risk of severe postpartum hemorrhage: A case-control study. PLoS One. 2017;12:e0175306. DOI: https://doi.org/10.1371/journal.pone.0175306

You S-H, Cheng P-J, Chung T-T, Kuo C-F, Wu H-M, Chu P-H. Population-based trends and risk factors of early- and late-onset pre-eclampsia in Taiwan 2001-2014. BMC Pregnancy Childbirth. 2018;18:199. DOI: https://doi.org/10.1186/s12884-018-1845-7

Soni M, Goyal G, Choudhary H, Soni A. Assessment of prognostic performance of HDP-Gestosis for pre-eclampsia prediction in pregnant women: a prospective analysis study. Int J Sci Res. 2024;13(12). DOI: https://doi.org/10.36106/ijsr/5113805

Downloads

Published

2025-09-26

How to Cite

B., D., Kailairajan, R., & Sethuraman, D. (2025). Hypertensive disorders in pregnancy gestosis score as a predictor of pre-eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(10), 3307–3313. https://doi.org/10.18203/2320-1770.ijrcog20253072

Issue

Section

Original Research Articles