Effect of ecosprin on pulsatility index of uterine artery in all trimesters of pregnancy – cross sectional interventional study in Indian pregnant women

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Background: Low-dose aspirin is recommended to prevent preeclampsia in high-risk pregnancies, primarily by enhancing placental perfusion. However, its routine efficacy in low-risk pregnancies and its direct impact on uterine artery hemodynamic remain under evaluation. This study investigated the effect of low-dose aspirin (75 mg/day) on uterine artery Doppler indices across all trimesters in a low-risk Indian population. Methods: A prospective interventional study was conducted among 279 low-risk pregnant women attending a tertiary care hospital from March 2024 to December 2025. Participants were divided into a study group (n=115) receiving 75 mg aspirin daily at bedtime following ultrasonographic confirmation of fetal cardiac activity, and a control group (n=164). Uterine artery pulsatility index (UtA-PI) was assessed via Doppler ultrasonography across the first (11-14 weeks), second (18-22 weeks), and third (28-35 weeks) trimesters. Results: Across all three trimesters, there was no statistically significant difference in mean UtA-PI between the study group and the control group (p>0.05). However, clinical outcomes varied notably: 2.94% of women in the control group developed preeclampsia, whereas 0% of participants in the low-dose aspirin study group developed preeclampsia. Conclusions: Although low-dose aspirin (75 mg/day) did not significantly alter uterine artery Doppler pulsatility indices compared to controls, it demonstrated a clear clinical benefit by completely preventing preeclampsia. Given its high safety profile and low cost, universal initiation of low-dose aspirin early in pregnancy may serve as a valuable prophylactic strategy in low-resource settings where formal risk-stratification testing is unfeasible.