Predictive Value of Uterine Artery Pulsatility Index in Placental Insufficiency across Gestational Stages in a Single Population

OBJECTIVES: To assess the predictive significance of the uterine artery pulsatility index (UTPI) for placental insufficiency (PI) during different stages of pregnancy within the same population, identify the optimal detection window, and elucidate its dynamic variation patterns. METHODS: w). PI, including preeclampsia (PE) and fetal growth restriction (FGR), was the primary outcome. Longitudinal UTPI trends were analyzed using generalized linear mixed models, and gestational stage-specific predictive performance was assessed using receiver operating characteristic (ROC) analysis. RESULTS: weeks, the UTPI showed comparable discriminative ability (AUC 0.78, 95% CI 0.62-0.92), with moderate sensitivity (66.7%, 95% CI 47.0-100.0) and high specificity (83.3%, 95% CI 45.0-97.0). CONCLUSIONS: weeks. Both groups exhibited similar UTPI decline patterns, indicating the presence of hemodynamic compensation in PI patients. These findings support the use of a phased UTPI monitoring strategy in high-risk pregnancies.