The Relationship between Uterine Artery Doppler Index and Adverse Pregnancy Outcomes: A Prospective Cohort Study

Increased Doppler indices of uterine artery correlate with adverse pregnancy outcomes. The present study was conducted with aim to investigate the relationship between elevated resistance in the pulsatility index (PI) of the uterine artery at 18-20 weeks of pregnancy and adverse pregnancy outcomes.

In this prospective cohort study, colour Doppler ultrasonography was performed on 173 patients referred to the perinatology office at Sabzevar University of Medical Sciences during 18-20 weeks of pregnancy. The 95th percentile of the average uterine PI was recorded. After delivery, adverse pregnancy and childbirth outcomes were evaluated. Data were analysed using SPSS (version 26) and Fisher's exact test and Mann-Whitney U test.

In terms of maternal and fetal outcomes, one case (2.3%) experienced intrauterine fetal death (IUFD), two (4.5%) had premature births, eight infants (18.2%) were hospitalized in the neonatal intensive care unit (NICU), and four (9.1%) had low birth weight (LBW). No cases of infant deaths or intrauterine growth restriction (IUGR) were reported. A significant relationship was found between mean PI exceeding 1.5 and high blood pressure during pregnancy (p=0.003). Additionally, significant relationship was found between an elevation in resistance beyond the 95th percentile of the PI and increased blood pressure (p=0.005) and premature delivery (p=0.04). However, no significant relationships were noted between mean and the 95th percentile of the PI and other maternal and fetal outcomes.

No cases of infant deaths and IUGR were reported. The elevated uterine artery PI is associated with increased risk of gestational hypertension and preterm delivery.