PAPPA and Hypertension: Uterine artery Doppler in the first trimester done along with early anomaly scan at 11-13+6 weeks has been found to be a good predictor of hypertension in pregnancy with moderate sensitivity and specificity. It is convenient and cost-effective to use PAPP-A as a biomarker since PAPP-A levels are routinely checked as a part of aneuploidy screening.