Role of uterine artery Doppler at 12 to 16 weeks of gestation in prediction of pre-eclampsia an observational study


  • Asha Neravi Department of Obstetrics and Gynecology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India
  • Voorkara Udayashree Department of Obstetrics and Gynecology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India



Preeclampsia, Pulsatality index, Resistance index, Uterine artery Doppler, Uterine artery diastolic notch


Background: Pre-eclampsia affects 2-5% of pregnancies and is a major cause of perinatal and maternal morbidity and mortality. Doppler is a non-invasive method for evaluation of feto-placental circulation without affecting pregnancy. A high resistance index in uterine artery Doppler waveform has been shown to be the best non-invasive screening test. Thus, we have conducted this study to find out the predictive value of transvaginal uterine artery doppler in early pregnancy for the prediction of pre-eclampsia. The aim of the study was early prediction of pre-eclampsia by trans-vaginal uterine artery Doppler study at 12-16 weeks.

Methods: According to the study criteria 100 antenatal women between 12 to 16 weeks of singleton pregnancy attending out patient in the Department of OBG of S. D. M. Medical College Dharwad were included. After an informed consent, the women underwent ultrasound for dating and subsequently trans-vaginal ultrasound along with color doppler was performed to obtain uterine artery indices. These women were again rescanned at 24-26 weeks of gestation trans-abdominally and further followed up clinically for development of preeclampsia.

Results: Out of 100 women, 22 patients developed preeclampsia. At 12-16 weeks 35% of women had bilateral uterine artery notching, mean RI was 0.57 and PI was 0.89. When uterine artery notch at 12-16 weeks alone was considered, 34.28% of women developed preeclampsia. Detection rate increased to 85.71% when RI>0.65 was also included along with notching. Uterine artery notching at 12-16 weeks gestation had 34.29% sensitivity, 84.62% specificity, 70.51% NPV. When notch and RI>0.65 considered together sensitivity and NPV increases to 85.71% to 98.25%.

Conclusions: The uterine artery Doppler waveform indices at 12-16 weeks are the best non-invasive screening test available for early prediction of preeclampsia.


Cantwell R, Clutton-Brock T, Cooper G. Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eighth report of the confidential enquiries into maternal deaths in “the eighth report of the confidential enquiries into maternal deaths in the United Kingdom,”. BJOG. 2011;118(1):1-203.

James, Steer, Weiner, Gonic, Crother, Robson. Hypertension. In: Dekker G, eds. High risk pregnancy management options. 4th Ed. Elsevier Saunders Publication; 2011;35:602.

Crovetto F, Crispi F, Scazzocchio E. First-trimester screening for early and late small-for-gestational-age neonates using maternal serum biochemistry, blood pressure and uterine artery Doppler. Ultrasound Obstet Gynecol. 2014;43(1):34-40.

Visser GHA, Bilardo CM, Lees C. Fetal growth restriction at the limits of viability. Fetal Diagnosis Therapy. 2014;36:162-5.

Poon LCY, Stratieva V, Piras S, Piri S, Nicolaides KH. Hypertensive disorders in pregnancy: combined screening by uterine artery Doppler, blood pressure and serum PAPP-A at 11-13 weeks. Prenatal Diag. 2010;30(3):216-23.

Akolekar R, Syngelaki A, Poon L, Wright D, Nicolaides KH. Competing risks model in early screening for preeclampsia by biophysical and biochemical markers. Fetal Diag Therapy. 2013;33(1):8-15.

Shashi G, Kumar GP, Preeti B, Anshu K. Transvaginal doppler of uteroplacental circulation in early prediction of pre-eclampsia by observing bilateral uterine artery notch and resistance index at 12-16 weeks of gestation. J Obset Gynecol India. 2009;59(6):541-6.

Khong SL, Kane SC, Brennecke SP, da Silva FC. First-trimester uterine artery doppler analysis in the prediction of later pregnancy complications. Dis Markers. 2015;2015:679730.

Ridding G, Schluter PJ, Hyett JA, McLennan AC. Uterine artery pulsatility index assessment at 11-13 weeks' gestation. Fetal Diag Therapy. 2014;36:299-304.

Gupte S, Wagh G. Preeclampsia-Eclampsia. J obstet Gynaecol India. 2014;64(1):4-13.

Casmoda Y, Van DykaE B, Nicolaoub. Uterine artery Doppler screening as a predictor of pre-eclampsia. Health SA Gesondheid. 2016;21:391-6.

Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, et al. Reference ranges for uterine artery mean pulsatility index at 11-41 weeks of gestation. Ultrasound Obstet Gynecol. 2008;32(2):128-32.






Original Research Articles