- the subsequent development of abnormal uterine artery Doppler velocimetry (UTDV) in the second trimester (2T). Study design: This study is based on a cohort study design to examine the predictive value of PlGF, sEng and sVEGFR-1 plasma concentrations in the identification of patients destined to develop PE. Only patients that had samples obtained between 8–13 weeks and subsequently had UTDV between 20–25 weeks were included (n = 1,316). Results: 1) Women destined to have abnormal UTDV in the 2T had a lower median 1T plasma PlGF concentration than those with normal UTDV; 2) 1T plasma PlGF concentration of < 26.8 pg/ml (derived by ROC analysis) was associated with abnormalities in UTDV in the 2T (odd ratio 3.2; 95% CI 1.8–5.5) after adjusting for confounders; and 3). Women with abnormal UTDV, with and without subsequent PE, had a lower median 1T plasma PLGF concentration than those with normal UTDV and no PE. Conclusion: A low 1T plasma PlGF concentration is associated with increased impedance to flow in the uterine circulation in the 2T, regardless of whether or not the patient developed PE. These findings suggest that PlGF plays an important role in early placentation.