Gestosis score
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Gestosis score obstetrics scoring system
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gestosis score
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https://pmc.ncbi.nlm.nih.gov/articles/PMC12236535/
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FOGSI gestosis score chart scoring table risk factors points
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https://www.ijrcog.org/index.php/ijrcog/article/download/141…
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https://hdpgestosisscore.com
HDP Gestosis Score (FOGSI) is a first-trimester clinical risk score used to identify women at risk of hypertensive disorders of pregnancy, especially pre-eclampsia.
Scoring
Add the points for all applicable risk factors:
| Risk category | Points | Risk factors |
|---|---|---|
| Mild | 1 each | Age >35 or <19 years; anemia; BMI >30; primigravida; short cohabitation/paternity duration; woman herself born small for gestational age; PCOS; interpregnancy interval >5 years; conception by ART (IVF/ICSI); mean arterial pressure (MAP) >85 mmHg; dyslipidemia/chronic vascular disease; excessive gestational weight gain |
| Moderate | 2 each | Hypothyroidism; family history of pre-eclampsia; gestational diabetes; multiple pregnancy; BMI >35; hypertensive disease in a previous pregnancy |
| Severe | 3 each | Pregestational diabetes; chronic hypertension; mental disorder; inherited/acquired thrombophilia; chronic kidney disease; autoimmune disease such as SLE, APS, or rheumatoid arthritis; ART pregnancy using donor oocyte or surrogacy |
Interpretation
- Score 0-2: lower risk
- Score ≥3: at risk / high risk for hypertensive disorders of pregnancy and pre-eclampsia
The score should be calculated at the booking or first antenatal visit and reviewed later because factors such as MAP, anemia, weight gain, GCT, and TSH can change. The official score describes 27 risk factors and uses 1, 2, and 3 points for mild, moderate, and severe factors respectively, with ≥3 as the action threshold. HDP Gestosis Score guidance
MAP formula:
[ \text{MAP} = \frac{\text{SBP} + 2(\text{DBP})}{3} ]
[ \text{MAP} = \frac{\text{SBP} + 2(\text{DBP})}{3} ]
Example: a primigravida with BMI 31 and MAP 88 has score 1 + 1 + 1 = 3, so she is classified as at risk.
This is a screening tool, not a diagnostic criterion for pre-eclampsia. A score ≥3 warrants obstetric assessment, closer BP and urine surveillance, and consideration of prevention measures such as low-dose aspirin when clinically appropriate, typically initiated early in pregnancy. A published study reported sensitivity 72.2% and specificity 94.6% for predicting pre-eclampsia, but performance may differ by population. Study scoring table and results
What prevention is recommended for a score of ≥3?
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FOGSI HDP Gestosis score 3 prevention aspirin dose 150 mg recommendation
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preeclampsia aspirin prevention
For an HDP Gestosis Score ≥3, FOGSI classifies the woman as at risk for hypertensive disorders of pregnancy and recommends:
- Low-dose aspirin 75 mg once daily, started as early as possible, ideally before 16 weeks of gestation. It may still offer benefit if started up to 20 weeks.
- Continue according to the treating obstetrician's protocol, commonly until around 36 weeks or delivery depending on local guidance.
- Closer antenatal surveillance: blood pressure, urine protein, fetal growth, and review of changing risk factors.
- Address modifiable factors such as anemia and excessive weight gain. Calcium supplementation may be considered when dietary calcium intake is low.
Important distinction: under the current FOGSI GCPR, 75 mg/day is recommended for women screen-positive on the Gestosis Score. 150 mg/day is generally reserved for women positive on a multimodal pre-eclampsia screening test, not automatically for Gestosis Score ≥3. FOGSI HDP recommendations
Aspirin should be prescribed after checking for contraindications, such as aspirin allergy, active bleeding/peptic ulcer disease, or a bleeding disorder.
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