Abstract: Background: Pre-eclampsia remains a major cause of maternal-perinatal morbidity. Early second-trimester uterine artery Doppler can identify impaired placentation and may help predict pre-eclampsia in routine antenatal care settings. This study assessed uterine artery Doppler indices at 20-24 weeks as predictors of pre-eclampsia at a government tertiary-care hospital in Barasat, West Bengal.
Methods: A prospective observational study was conducted over one year among 100 singleton pregnancies undergoing uterine artery Doppler at 20-24 weeks’ gestation. Left and right uterine artery pulsatility index (PI) were measured and mean PI calculated; notching was recorded. Abnormal Doppler was defined as mean uterine artery PI ?1.30 and/or bilateral early diastolic notching. Participants were followed until delivery for development of pre-eclampsia. Diagnostic accuracy indices were calculated, and ROC analysis was performed for mean PI.
Results: Pre-eclampsia occurred in 12% (12/100), including 4 early-onset (<34 weeks) and 8 late-onset (?34 weeks) cases; 5/12 (41.7%) had severe features. Mean uterine artery PI was higher among women who developed pre-eclampsia (1.49±0.25) than those who did not (0.99±0.21). Abnormal Doppler was present in 20% overall and was associated with a higher pre-eclampsia incidence (40.0% [8/20] vs 5.0% [4/80]). Abnormal Doppler predicted pre-eclampsia with 66.7% sensitivity, 86.4% specificity, PPV 40.0%, and NPV 95.0% (LR+ 4.89, LR? 0.39). Mean PI showed strong discrimination for pre-eclampsia (AUC 0.94).
Conclusion: Uterine artery Doppler at 20-24 weeks provided clinically useful prediction of pre-eclampsia, with strong rule-out value and clear risk stratification. Incorporation into routine mid-trimester ultrasound may support targeted surveillance in government antenatal services.
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