الفهرس 
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Abstract
Introduction: Preeclampsia (PE) is still a major obstetrical problem world-wide. It is one of three major factors causing maternal and fetal morbidity and mortality, and at the same time being one of the most important factors responsible for preterm birth. Currently, there is no treatment for PE other than delivery. Furthermore, the lack of specific predictive and diagnostic tools makes clinical handling of the disease a global maternal health problem with many unmet clinical needs. Aim of this study: The aim of this study was to assess the relationship between 1st trimester uterine artery pulsatility index (UtA PI) and the development of preeclampsia in high risk women. Patients and methods: This is a prospective observational study conducted at Mansoura University Hospital and Damietta general hospital. Methods:. The patients were recruited Outpatient obstetrics & Gynecology Clinic. Sample size was calculated via Epi-info software (version 7), the estimated sample size was 107, this number will be increased by about 10% (11 patients) to overcome the loss of follow up. So, this study was conducted on 118 pregnant women who attended their routine antenatal care visits at the Outpatient obstetric & Gynecology Clinic of Mansoura University Hospital. Written informed patients consents were obtained after approval by Local Ethical Research Committee in Mansoura Faculty of Medicine. The inclusion criteria were nulliparous pregnant women, with a singleton pregnancy, of 11 to 13 weeks gestational age, aged less than 17 or more than 35 years and having BMI > 25. All patients will be subjected to full history taking, clinical examination including blood pressure measurement and ultrasound examination; ultrasound assessment of uterine artery Doppler velocimetry was performed using color Doppler in the 2D mode, and flow velocity waveforms were obtained from the ascending main branch of the uterine artery on the right and left sides of the cervix in a longitudinal plane before they entered the uterus, or from the proximal part of the main UtA. Both sides Doppler indices from the abdominal scan was taken and the average was calculated. Results:. Data was tabulated and introduced into a PC using MedCalc_ version 17.9.7 (MedCalc Software bib, Ostend, Belgium) for analysis using suitable tests then presentation. The mean age of the study participants was 36.33 years, with 4.58% of them were ≤ 17 years and 95.42% were ≥ 35 years. The mean BMI was29.43 Kg/m2, 54.63% of them had a mean value of 25 - < 30 and 45.37% had a mean value ≥ 30 Kg/m2. The mean gravidity was 1.81 times and few number of participants (7.34%) were having > 3 pregnancies. The mean GA was 12.11 weeks. The mean Ut A PI was 1.74, and that 11% of the study participants developed early onset preeclampsia. On the comparison between the normal participants and the patients developed early onset preeclampsia at the follow up, there were statistically high significant difference between both groups in the BMI (p = 0.003), and no statistically significant difference as regards the age, gravidity and gestational age (p > 0.05). Statistically significant difference was evident between two groups in the mean values of Ut A PI (p = 0.028). There was statistically significant difference between the two groups in the distribution of BMI categories. While, no statistically significant differences were noted as regarding the age groups as well as the number of gravidity. The best cutoff value of Ut A PI for the prediction of early onset preeclampsia was ≥ 2.03 with accuracy of 0.79, and that of BMI was ≥ 35 with accuracy of 0.93.