{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:01:22Z","timestamp":1791262882479,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2005,9,23]],"date-time":"2005-09-23T00:00:00Z","timestamp":1127433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To establish reference values for the first\u2010trimester uterine artery (UtA) pulsatility index (PI) and to investigate the role of UtA Doppler in the early prediction of hypertensive disorders and their associated complications in an unselected Mediterranean population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective study including 1091 consecutive singleton pregnancies undergoing routine early ultrasound screening at 11\u201314 weeks of gestation was performed. The left and right UtA were examined by color and pulsed Doppler transvaginally. The mean PI and the presence of bilateral protodiastolic notching were cross\u2010sectionally recorded. Reference ranges were calculated and the pregnancies were followed for occurrence of pre\u2010eclampsia, gestational hypertension, intrauterine growth restriction, placental abruption and stillbirth. The sensitivity and predictive values of a mean UtA\u2010PI &gt; 95<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> percentile and the presence of bilateral notching in the prediction of these pregnancy complications were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 999 women were finally included. Both the mean UtA\u2010PI and the prevalence of bilateral notches showed a significant linear decrease between 11 and 14 weeks' gestation. Sixty\u2010seven (6.7%) pregnancies developed at least one of the formerly described complications, including 22 (2.2%) cases of pre\u2010eclampsia and 37 (3.7%) cases with intrauterine growth restriction. Compared with women with a normal outcome, complicated pregnancies showed a significantly higher mean PI (2.04 vs. 1.75; <jats:italic>P<\/jats:italic> &lt; 0.05, <jats:italic>t<\/jats:italic>\u2010test) and a higher prevalence of bilateral notching (58% vs. 41%; <jats:italic>P<\/jats:italic> &lt; 0.05, Chi\u2010square test). Using the 95<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> percentile in mean UtA\u2010PI as a cut\u2010off, 23.9% (95% CI, 13.7\u201334.1) of complicated pregnancies and 30.8% (95% CI, 5.68\u201355.85) of severe cases were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest that pregnancies with an increased risk of developing hypertensive disorders and related complications already have an abnormally increased UtA\u2010PI in early pregnancy. However, the use of a single uterine Doppler measurement for screening purposes in unselected early pregnancy populations has limited clinical value. The use of UtA\u2010PI combined with other screening tests needs to be determined by further investigation. Copyright \u00a9 2005 ISUOG. 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