Background:The study's primary objective is to investigate the relationship between uterine artery pulsatility index (P.I.) values and antiphospholipid antibodies (APLA) values. This analysis seeks to discern potential correlations or interactions between these two parameters, shedding light on their interplay in the context of pregnancy complications. Additionally, the study aims to observe pregnancy outcomes in distinct scenarios: first, where uterine artery P.I. values are elevated while the APLA profile remains normal, and second, when both uterine artery P.I. and APLA profiles show abnormalities.Methods: A prospective study included 340 pregnant women with a history of recurrent miscarriage linked to antiphospholipid antibodies. These individuals received a combination of low-dose aspirin and heparin. Doppler assessments of uterine arteries were conducted at 16–18 and 22–24 weeks to identify notches and measure the pulsatility index. Results:Out of 234 pregnancies, 228 resulted in live births, and six experienced midtrimester losses. Preeclampsia and small-for-gestational-age (SGA) prevalence was both 10%. Uterine artery pulsatility index at 16–18 and 22–24 weeks was not predictive for preeclampsia or SGA. Doppler accuracy was limited, except for bilateral uterine artery notches at 22–24 weeks in the lupus anticoagulant-positive subgroup. It showed high predictive value with 76% sensitivity, 93% specificity, and 76% positive and 93% negative predictive values. These findings highlight Doppler's nuanced role in specific subgroups for predicting adverse pregnancy outcomes with antiphospholipid antibodies.Conclusion:In pregnancies linked to lupus anticoagulant, uterine artery Doppler at 22–24 weeks proves to be a valuable screening test for predicting both preeclampsia and small-for-gestational-age (SGA) infants.