Uterine Artery Doppler Assessment in Pregnancy Complications

Uterine artery Doppler examination employs pulsed-wave ultrasound to characterise blood flow in the uterine arteries as a window into placental function. Abnormal impedance indices, most commonly the pulsatility index or resistance index and the presence of a protodiastolic notch, reflect impaired trophoblast invasion and elevated downstream resistance. Such findings have been linked to pre-eclampsia, fetal growth restriction and small-for-gestational-age pregnancies. Over the course of gestation, normal uterine artery impedance declines non-linearly, with steep reduction in the first half of pregnancy followed by milder changes later on. Deviations from gestational-age specific reference ranges can prompt early intervention strategies, including low-dose aspirin prophylaxis, intensified surveillance and targeted delivery planning. Global studies have established centile charts across diverse populations, highlighting the need for locally validated reference values. Integration of uterine artery Doppler with maternal factors and biochemical markers has increased detection rates for early-onset disease. In clinical practice, this non-invasive assessment supports risk stratification, guides therapeutic decisions and underpins research into the maternal cardiovascular contribution to pregnancy outcomes.

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Uterine Artery Doppler Assessment in Pregnancy Complications publication trend

The graph below shows the total number of articles in uterine artery doppler assessment in pregnancy complications across all publications each year (not limited to Nature Index journals).

Technical terms

Pulsatility index: A Doppler measure of blood flow velocity variation across the cardiac cycle, indicating downstream resistance.

Resistance index: Ratio derived from peak systolic and end-diastolic velocities, reflecting vascular impedance.

Protodiastolic notch (early diastolic notch): A notch in the Doppler waveform early in diastole, signifying high distal resistance.

Utero-placental circulation: The vascular network supplying maternal blood to the placenta via uterine and spiral arteries.

Trophoblast invasion: The process by which placental cells penetrate maternal decidua to remodel uterine vessels.

References

1. Reference ranges of uterine artery pulsatility index from first to third trimester based on serial Doppler measurements: longitudinal cohort study. Ultrasound in Obstetrics and Gynecology (2023).
2. Mid‐trimester uterine artery Doppler for aspirin discontinuation in pregnancies at high risk for preterm pre‐eclampsia: Post‐hoc analysis of StopPRE trial. BJOG An International Journal of Obstetrics & Gynaecology (2023).
3. Preeclampsia: The Relationship between Uterine Artery Blood Flow and Trophoblast Function. International Journal of Molecular Sciences (2019).
4. Maternal History and Uterine Artery Doppler in the Assessment of Risk for Development of Early‐ and Late‐Onset Preeclampsia and Intrauterine Growth Restriction. Obstetrics and Gynecology International (2009).
5. A Review of Roles of Uterine Artery Doppler in Pregnancy Complications. Frontiers in Medicine (2022).
6. Reference range of uterine artery Doppler parameters between the 11th and 14th pregnancy weeks in a population sample from Northeast Brazil. Revista Brasileira de Ginecologia e Obstetrícia (2013).