The Use of Uterine Artery Doppler to Predict Pre-Eclampsia

This meta-analysis aimed primarily to comprehensively evaluate the predictive value of uterine artery Doppler ultrasound (UAD) for preeclampsia. The primary objective was to assess the diagnostic accuracy of key Doppler parameters—pulsatility index (PI), resistive index (RI), and the Prediction of notching—in predicting preeclampsia across diverse populations and gestational ages Additionally, secondary objectives were to determine whether combining Doppler findings with maternal clinical risk factors enhances early identification of women at risk, ultimately informing clinical screening practices and guiding future research efforts. In this study, preeclampsia is considered a major contributor to maternal and perinatal morbidity and mortality, underscoring the need for effective early prediction methods. Furthermore, UAD has been extensively studied as a non-invasive tool for assessing uterine and placental blood flow abnormalities associated with preeclampsia. This systematic review and meta-analysis synthesize evidence from studies published between 2005 and 2024 to evaluate the diagnostic accuracy of uterine artery Doppler parameters, including pulsatility index (PI), resistive index (RI), and the presence of rupture, in predicting preeclampsia. The analysis highlights that second-trimester Doppler assessments, particularly PI and RI, demonstrate moderate to high sensitivity and specificity, while combining Doppler measurements with maternal clinical risk factors significantly improves predictive performance. Despite some inter-study variability, the findings support the incorporation of uterine artery Doppler into routine prenatal screening protocols to enhance early detection and management of preeclampsia. Future research should focus on standardizing Doppler protocols and validating combined predictive models to improve clinical outcomes.