Combined Placental Laterality and Mid-Trimester Uterine Artery Dopplers; A Promising Tool for Predicting Preeclampsia Onset in Low-Resource Settings

Objective: Preeclampsia poses a major risk to feto-maternal well-being, particularly in low-resource settings where access to predictive biomarkers is limited. This study evaluated placental laterality and uterine artery Doppler indices as affordable, non-invasive predictors of preeclampsia. Methodology: A prospective seven-month study (January–July 2022) was conducted at the Fetal Assessment Centre, Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana. Normotensive pregnant women between 18–24 weeks underwent ultrasound studies for placental location and uterine artery doppler indices and were followed until delivery. Sociodemographic data were analysed using descriptive statistics, while chi-square tests were used for bivariate analysis. Screening tests for sensitivity and specificity in predicting preeclampsia were performed for lateral placentation and abnormal doppler velocimetry. Statistical significance was set at p < 0.05. Results: Of 132 women completing the study, 6.1% (8/132) developed preeclampsia, all with severe features. Preeclampsia incidence was significantly higher with lateral compared to central placentas [12.1% (8/66) vs 0.0% (0/66), p = 0.003]. Among women with lateral placentas, abnormal pulsatility and resistive indices, systolic/diastolic ratios, bilateral diastolic notching, and positive combined tests were significantly associated with preeclampsia development (62.5% vs 14.0%, p = 0.007; 62.5% vs 18.0%, p = 0.015; 100.0% vs 52.0%, p = 0.016; 100.0% vs 8.0%, p = 0.017; 62.5% vs 6.0%, p = 0.006, respectively). Conclusion: Combining placental laterality with uterine artery doppler indices provides a cost-effective, accessible method for early preeclampsia prediction in resource-limited settings, potentially improving feto-maternal outcomes through timely intervention.