Color Doppler Evaluation of Uterine Artery Indices in Prediction of Preeclampsia and Fetal Growth Restriction: A Prospective Observational Study

Background: Abnormal remodeling of the uteroplacental circulation can persist as increased uterine arterial resistance, preceding placental dysfunction and adverse outcomes. Objectives: To evaluate mid‑trimester uterine artery Doppler indices and early diastolic notching for predicting preeclampsia and fetal growth restriction. Methods: A prospective observational study was conducted in 100 singleton pregnancies undergoing uterine artery color Doppler at around 22 weeks’ gestation. Pulsatility index, resistance index, systolic/diastolic ratio, and early diastolic notch were recorded. Participants were followed until delivery to ascertain preeclampsia and fetal growth restriction. Results: Uterine artery impedance indices were higher in pregnancies that later developed preeclampsia and/or fetal growth restriction compared with uncomplicated pregnancies. Early diastolic notching was more frequent among women with adverse outcomes. A uterine artery pulsatility index above the 95th percentile for gestational age showed useful discrimination, with a high negative predictive value for the composite adverse outcome. Conclusion: Mid‑trimester uterine artery Doppler, particularly elevated pulsatility index and the presence of early diastolic notching, is a practical non‑invasive approach to stratify risk for preeclampsia and fetal growth restriction in routine antenatal care