Pre-eclampsia, a condition unique to human pregnancy, is a significant cause of maternal and neonatal morbidity and mortality.The objective of this study is to evaluate the value of ultrasound determination of placental location, umbilical cord thickness and abnorml Doppler waveforms in the prediction of pre-eclampsia and correlations between these findings and the severity of pre-eclampsia.Conventional ultrasound and Doppler velocimetry were done first between 14-16 weeks and then rescreening between 24-26 weeks. The group of late normalizers (35 cases) were followed up for manifestations of pre-eclampsia. The group of persistent abnormal Doppler findings (55 cases) was divided into two groups: Aspirin group (28 cases) and non-aspirin group (27 cases).A laterally located plcenta was associated with increased risk of pre-eclampsia. Also the presence of abnormal Doppler findings (increased RI, increased S/D ratio and presence of diastolic notch especially if bilateral) was associated with significant increased risk of pre-eclampsia especially severe forms.Umbilical cord thickness showed no significant correlation with pre-eclampsia. Low dose aspirin was found to modulate the course of pre-eclampsia and decrease severe cases rather than prevent its occurance.Doppler screening of the uterine artery can become part of routine antenatal care (especially if patient has high risk of pre-eclampsia). No other method of predicting pre-eclampsia has combined such good predictive values with simple, non-invasive methodology.