Comparison of maternal history, mean arterial pressure and uterine artery Doppler at 11-14 weeks of pregnancy with adverse pregnancy outcomes

Background: During pregnancy, the maternal body undergoes significant anatomical and physiological changes to support fetal development. Poor placentation can lead to placental insufficiency, which is associated with complications such as preeclampsia, preterm labor, intrauterine growth restriction (IUGR), and stillbirth. Risk factors like hypertensive disorders, smoking, drug use, and advanced maternal age increase the likelihood of placental insufficiency. Changes in Mean Arterial Pressure (MAP) and Uterine Artery Doppler (UAD) are important indicators of placental dysfunction, a condition affecting 10-15% of pregnancies. While many studies support early trimester screening with biochemical parameters, particularly in developed countries, access to these markers remains limited in developing nations, reducing the chances of identifying high-risk pregnancies. This study focuses on easily available assessments for screening.Objectives: This study aimed to evaluate the clinical significance of Uterine Artery Doppler Pulsatility Index (PI) at 11-14 weeks gestation and assess the roles of maternal history and MAP in predicting adverse pregnancy outcomes.Materials and Methods: A prospective study was conducted at a tertiary care hospital in South India involving 90 pregnant women at 11-14 weeks gestation. Maternal history, UAD, and MAP were recorded. Abnormal findings were defined as UtA-PI ≥ 1.9 and MAP ≥ 105 mmHg. Outcomes were analyzed using SPSS- 21 software with a 5% significance level.Results: Maternal history had a sensitivity of 92.31% and specificity of 34.21%. MAP showed moderate predictive power for preeclampsia (AUC 0.724) and fetal growth restriction (AUC 0.647). UtA-PI ≥ 1.9 exhibited high predictive accuracy (sensitivity 85.29%, specificity 98.24%).Conclusion: The results underscore varying levels of predictive ability among maternal history, mean arterial pressure, and uterine artery pulsatility index in assessing pregnancy outcomes, with UtA-PI showing the highest predictive power overall and we further emphasize the need for standardized measurements using combined screening for consistent results across different clinical settings.