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Bleeding and miscarriage are the most common causes of seeking medical advice in early pregnancy (1) and spontaneous miscarriage is clinically recognized pregnancy loss before the viability (2). Therefore, effective management techniques and prophylactic strategies can be offered to save a life if a screening test is available that can signal upon the likelihood of miscarriage in the near future (1). Although the definite cause of miscarriage cannot be addressed in most of the cases, when bleeding happens, it could be expected that a vascular injury may be the primary or secondary cause (3). Normal implantation and placentation are of great importance for achieving a normal pregnancy. The main event during this period is the trophoblastic cell invasion to the inner third of the myometrium and migration through the entire length of maternal spiral arteries. In addition, the vascular remodeling of these high resistance arteries in the maternal-fetal interface results in low resistance and high flow state in the intervillous space (4). This is associated with a concomitant increase in uterine blood flow and perfusion that regulates uterine receptivity and is crucial for the normal pregnancy outcome (5,6). These changes are reflected in uterine artery Doppler studies by a progressive reduction in the uterine arterial blood flow resistance at five weeks after implantation (4,7). Extensive evidence is present regarding the benefit of uterine artery Doppler ultrasound for assessing uteroplacental perfusion and predicting the future development of pre‐eclampsia, fetal growth restriction, placental abruption, and stillbirth in the second trimester (8,9). However, the researchers have not so far reached a concrete consensus about using uterine Doppler measurements for predicting the adverse outcomes in the early stages of pregnancy between 6-14 weeks. Accordingly, the present sought to determine any association between the uterine artery Doppler measurements and the outcome of pregnancy in this early gestational period. These measurements can be utilized to predict or identify women with complicated pregnancies or higher probability of miscarriage if there is such an association.

Doppler Ultrasound Screening of the Uterine Arteries as a Predictor for Early Miscarriage