⏳Uterine Artery Doppler and Preeclampsia: What Is the Link?

Preeclampsia is primarily a placental disease.

Its roots begin early long before blood pressure rises or symptoms appear.

Uterine artery Doppler helps us assess how well the placenta is forming and functioning during early pregnancy.

🔹 What is the connection?

In normal pregnancy, uterine arteries gradually adapt to allow low-resistance blood flow to the placenta.

In pregnancies that later develop preeclampsia, this adaptation may be incomplete or abnormal, leading to: 

• Increased resistance to uteroplacental blood flow

• Reduced placental perfusion

• Placental ischemia and dysfunction

These changes can be detected by uterine artery Doppler.

🔹 What abnormal Doppler findings suggest:

✔️ Higher risk of early-onset preeclampsia

✔️ Increased risk of placental insufficiency

✔️ Association with fetal growth restriction

✔️ Need for closer antenatal surveillance

Findings such as high resistance indices or persistent diastolic notching reflect impaired placentation  a key mechanism in preeclampsia.

🔹 What Doppler cannot guarantee:

❌ A normal Doppler does not rule out preeclampsia

❌ An abnormal Doppler does not mean preeclampsia is inevitable

❌ It cannot predict exact timing or severity

🔹 Why timing matters:

Uterine artery Doppler is most informative when performed in the first and early second trimester, when placental development is still ongoing.

Later in pregnancy, its value is limited for prediction, but may still support overall clinical assessment.

🎯 Key message:

Uterine artery Doppler does not diagnose preeclampsia.

It helps us understand risk early, before clinical disease appears.

It is a tool for risk stratification, not reassurance

and it works best when combined with clinical judgment and continuous follow-up.

Dr Rabab Cares

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