Abstract: Objective To explore the relationship beriween plasma D-dimer, serum uric acid and umbilical artery flow index (UA-S/D) and the maternal and fetal outcomes of preeclampsia pregnant women.Methods A total of 90 patients with preeclampsia who were admitted to the First People's Hospital of Taican fromg June 2020 to May 2022 were selected and set as a preeclampsia group, while another 90 normal pregnant women in the same hospital during the same period were selected as a control group. Their clinical data were retrospectively analyzed. Their D-dimer, uric acid, UA-S/D and pregnancy outcome were compared, and the relationships between D-dimer, uric acid, UA-S/D and maternal fetal outcome were analyzed.Results The severe and moderate to mild preeclampsia groups showed significantly shorter gestational ages at admission and delivery and lower newborn birth weight than the control group (P<0.01), as well as higher levels of D-dimer, uric acid, and UA-S/D than the control group (P<0.01). The incidences of placental abruption, oligohydramnios, intrauterine growth restriction, fetal distress, premature delivery, and cesarean section in the severe and mild-moderate preeclampsia groups were remarkably higher than those in the control group (P<0.05). The levels of D-dimer, uric acid, and UA-S/D in the severe preeclampsia group were negatively correlated with gestational ages (r=-0.33, -0.26, and -0.29, P<0.05), and negatively correlated with neonatal birth weight (r=-0.23, -0.22, and -0.25, P<0.05).Conclusions The levels of D-dimer, uric acid and UA-S/D in the preeclampsia pregnant women increase, which are related to adverse maternal and fetal outcomes.