Role of Uterine Artery Doppler in the Second Trimester for Predicting IUGR in High-Risk Pregnancies

Background: Intrauterine growth restriction (IUGR) remains one of the major challenges in obstetrics, carrying a high risk of perinatal illness and death. To improve early detection, uterine artery Doppler studies during the second trimester are now widely used, as they provide valuable insight into placental blood flow and help identify pregnancies at risk for adverse outcomes. Aim and Objective: The aim of this study is to assess how well second-trimester uterine artery Doppler indices can predict intrauterine growth restriction (IUGR) in high-risk pregnancies, and to compare neonatal outcomes between those with normal versus abnormal Doppler findings. Materials and Methods: Between March 2023 and February 2024, we conducted a prospective observational study at a tertiary-level teaching hospital. The study population included 120 pregnant women identified as high risk and presenting between 20 and 24 weeks of gestation. Women were categorized as high risk if they had conditions such as prior intrauterine growth restriction, preeclampsia, chronic hypertension, or gestational diabetes. Each participant underwent uterine artery Doppler assessment with a high-resolution ultrasound system. The evaluation focused on calculating the mean pulsatility index (PI) and checking for the persistence of an early diastolic notch. Doppler findings were classified as abnormal when the mean PI exceeded 1.45 and/or bilateral notching was observed. All women were followed until delivery, and pregnancy outcomes including the occurrence of IUGR, neonatal birth weight, requirement for NICU care, and perinatal mortality—were systematically recorded. Results: Out of the 120 women studied, abnormal uterine artery Doppler findings were observed in 38 cases (31.7%). Among these, more than half [22 women (57.9%)] subsequently developed IUGR, whereas only 10 women (12.2%) with normal Doppler readings were affected, a difference that was highly significant (p