Adverse pregnancy outcome due to impaired placentation have been shown to demonstrate increased impedance in the spiral artery. The spiral arteries are rstly invaded by trophoblasts and which then becomes incorporated into the vessel wall and replaces the endothelium and muscular layer. This results in the conversion of the small spiral arteries into vessels of greater diameter with low resistance and high compliance, in absence of maternal vasomotor control. This study was a Prospective Observational study, carried out in the Department of Obstetrics and Gynaecology, in JLNMCH, Bhagalpur, Bihar. The study population consisted of pregnant women between 18 – 20 weeks of gestation with viable pregnancy. During pregnancy, 63(18.36%) women developed hypertensive disorders. Among these 63 patients, 37(58.73%) women had increased uterine artery pulsatility index in second trimester scan and 26(41.26%) had normal pulsatility index. The results were comparable for gestational hypertension with normal and unilaterally increased uterine artery PI and were not statistically signicant.