Sina Salem Ahim
1 
, Maryam Kazemi
2 , Melika Boroomand-Saboor
3 , Zeinab Zamanpour
4 , Hamideh Rahbarinezhad
5 , Tahereh Mahmoodvand
6 , Sara Ghaseminejad Kermani
7 , Sadaf Rassouli
8 , Zahra Hamidi Madani
9* 1 Fasa University of Medical Sciences, Fasa, Iran
2 Department of Obstetrics and Gynecology, Imam Hossein Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
3 Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Gynecology and Obstetrics, School of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
5 Department of Radiology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
6 Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Emergency Medicine, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department of Gynecology and Obstetrics, Imam Khomeini Hospital, School of Medicine, Sari University of Medical Sciences, Sari, Iran
9 Department of Obstetrics and Gynecology, Reproductive Health Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Abstract
Introduction: Preeclampsia (PE) is a leading cause of maternal and perinatal morbidity worldwide, and early identification of at-risk pregnancies remains a clinical priority. This systematic review synthesizes evidence from the past decade to evaluate the diagnostic performance and clinical utility of uterine artery Doppler (UAD) sonography in predicting and guiding management of PE.
Materials and Methods: We systematically searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar for English-language original studies published between 2016 and 2025 that evaluated UAD parameters for predicting PE. Two reviewers independently extracted data on study design, gestational timing, Doppler findings, and diagnostic accuracy using a standardized form.
Results: In this review of 18 observational and cohort studies published over the past decade, UAD sonography demonstrated moderate to high diagnostic accuracy for predicting PE, with parameters such as pulsatility index (PI), resistive index (RI), and the presence of a diastolic notch, alone or in combination, yielding sensitivities ranging from ~60% to 91% and specificities up to 99%. First-trimester assessments showed particular promise, especially when Doppler indices were combined with biochemical markers, and second-trimester measurements maintained predictive value for both early- and late-onset disease.
Conclusion: These findings pose UAD sonography as a noninvasive, cost-effective tool for early risk stratification of PE and support its incorporation into routine antenatal screening.
Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251173030 and the Research Registry (UIN: reviewregistry2054) websites.