Incidence of preeclampsia is 10% worldwide. More than 70% of preeclampsia occur at term. Maternal mortality from preeclampsia/eclampsia accounts for 63000 maternal deaths per annum worldwide, maximum being in low- middle income countries. Preeclampsia set in after 34 weeks of gestation is termed as late onset PE.⁽²⁾ In late onset preeclampsia, cause is more likely an increasing mismatch between normal maternal perfusion and metabolic demands of the placenta and fetus, coupled with a maternal predisposition to inflammation, high BMI or high arterial pressure.⁽³⁾ Considering the rising incidence of gestational hypertension, preeclampsia and PE associated comorbidity, various ways of early detection of risk of PE development in pregnancy are being researched all across the world since pasttwodecades.Mostofthemethodsfocusonthedetectionofearlyonsetpreeclampsiawhich constitute about 40-50% of the cases. More than 70% cases occur at term, if a screening method is introduced at 34 weeks, many mothers who are high risk for late onset preeclampsia can be detected early. Ophthalmic artery indices like PSV ratio, PI are being studied world wide at present.

The study conducted by Riskin Mashiah et al & Belfort et al (13,14) supported the evidence of development of PE is preceded by the decrease in the impedance to flow in the cerebral circulation. The ophthalmic artery, which is the first branch of the internal carotid artery has embryological, anatomical and functional similarities with the intracranial vasculature, is an easily accessible vessel for Doppler assessment that provides information on the less accessible intracranial circulation. Thus the use of Ophthalmic artery in prediction of PE is recently being investigated for its role in predicting preeclampsia worldwide and found to be beneficial.

We are proposing a Prospective observational study, to be conducted at Fernandez Hospital, Hyderabad  in the Department of Fetal Medicine, with 407 Study subjects. Patient population comprises of pregnant mothers visiting different branches of Fernandez Hospital for growth scan between 34 to37 weeks. Ophthalmic artery waveforms shall be obtained in sequence from the right eye, left eye and again from the right and then left eye. The following three indices will be used for analysis: first peak of systolic velocity; second peak of systolic velocity and the ratio of the second to first peak of systolic velocity (PSV ratio). Women will be then followed till their childbirth and details of mean arterial pressure at the time of OPD visits in third trimester, development of preeclampsia or eclampsia will be collected. Data about mode of delivery, development of fetal growth restriction shall be collected from the inpatient records. Entire data shall be analyzed.