Prediction of preeclampsia using first- trimester uterine artery doppler and gestosis score in primigravid: A prospective comparative study

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Introduction: Preeclampsia is a major contributor to maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries. Early identification of high-risk women in the first trimester is essential for timely intervention. Simple clinical tools such as the Gestosis score and uterine artery Doppler have been proposed for early prediction, but their comparative and combined effectiveness remains uncertain. Objectives: To compare the predictive value of the Gestosis score and first-trimester uterine artery Doppler for early detection of preeclampsia in primigravida women and to evaluate whether their combined use improves risk stratification. Methods: This prospective observational study included 150 primigravida women at 11–13?? weeks of gestation. Gestosis score was calculated (cutoff ?3), and uterine artery Doppler was performed to assess pulsatility index and notching. Participants were followed till delivery, and preeclampsia was diagnosed as per standard criteria. Sensitivity, specificity, PPV, NPV, and ROC analysis were calculated. Results: Preeclampsia developed in 11.3% of participants. Gestosis score showed sensitivity 76.5% and specificity 74.4%, while uterine artery Doppler showed sensitivity 70.6% and specificity 80.5%. Combined screening achieved 100% sensitivity and NPV, with the best predictive performance (AUC 0.869). Conclusion: Both methods are effective for early prediction of preeclampsia; however, combined screening provides superior accuracy and risk stratification, making it a valuable approach in clinical practice.

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