Objective: To assess uterine artery Doppler waveforms and notches performed in the third trimester as a predictor of adverse outcomes. Methods: Of 490 preeclampsia (PE) patients between 24 and 34 weeks gestation, 166 were diagnosed with mild PE and 324 were diagnosed with severe PE. Patients were divided into four groups (no notch, a unilateral notch, bilateral notches and double notches). Results: Bilateral and double notches were predictive of shorter follow-up times, adverse laboratory outcomes, HELLP syndrome, prematurity, neonatal intensive care unit admission and perinatal mortality. Conclusion: Double notches represent progressive deterioration in the uterine artery and are predictive of adverse maternal outcomes.