KUMJ | VOL. 24 | NO. 2 | ISSUE 95 | APRIL - JUNE, 2026
Study of First Trimester Uterine Artery Doppler Screening for Predicting Adverse Pregnancy Outcomes
Lama S, Shrestha A, Shakya S
Abstract: Background
Hypertensive disorders of pregnancy are the second leading cause of maternal
and perinatal morbidity and mortality, complicating 5–10% of pregnancies. Early
detection and prophylactic interventions can reduce adverse outcomes. Firsttrimester
uterine artery Doppler is a noninvasive tool for predicting and detecting
abnormal placental perfusion.
Objective
To determine the role of first-trimester uterine artery pulsatility index (PI) in
predicting hypertensive disorders and adverse pregnancy outcomes and to evaluate
pregnancy outcomes in patients with abnormal uterine artery Doppler who are
treated with aspirin.
Method
A prospective cohort study was conducted at Dhulikhel Hospital for one year period.
Uterine artery Doppler was performed at 11 to 13 weeks 6 days, and mean PI ≥ 1.5
was abnormal and normal if pulsatility index < 1.5. Women with PI ≥ 1.5 received
low-dose aspirin 150 mg until 34 weeks. Participants were followed until delivery;
maternal and fetal outcomes were recorded. Statistical analyses were done with p <
0.05 considered significant.
Result
Of 202 women, 177 (87.6%) had PI ≥ 1.5. Hypertension developed in 25 cases (12.4%),
predominantly in the high-PI group. First-trimester PI had a sensitivity of 96% and
specificity of 13.6% for predicting hypertension. Complications included hemolysis,
elevated liver enzyme and low platelet (HELLP) and abruptio in 1%, oligohydramnios
7.43%, fetal growth restriction (FGR) 18.8% and stillbirth 0.5%.
Conclusion
First trimester uterine artery Doppler ultrasound is a valuable screening tool for early
prediction of adverse pregnancy outcomes and should be implemented in prenatal
care protocol. Starting low dose aspirin in early pregnancy improves placental
perfusion reducing maternal and fetal complications.
Keyword : Aspirin, Doppler ultrasound, Fetal growth restriction, Hypertension, Preeclampsia, Pregnancy outcome
