Absence of a Relationship Between Umbilical Cord Thickness and Coiling Patterns

Abstract

Objective. The purpose of this study was to evaluate a relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the second trimester of pregnancy. Methods. This was a prospective study of 470 patients with singleton pregnancies who had a fetal anatomic survey with recorded umbilical coiling patterns between 18 and 23 weeks' gestation. The umbilical cord thickness was assessed as an umbilical diameter at the level of the fetal abdominal cord insertion and compared with the antenatal umbilical coiling index (aUCI), calculated as a reciprocal value of the distance between a pair of umbilical cord coils. Results. Three hundred twenty-one patients had adequate sonographic umbilical cord images and maternal demographic, antenatal, and labor data to meet inclusion criteria. The mean aUCI was 0.41 with 10th and 90th percentiles of 0.21 and 0.60, respectively. A total of 10.6% (34/321) and 9.3% (30/321) of patients were categorized as having hypocoiled and hypercoiled umbilical cords, respectively. The mean cord diameter ± SD was 9.48 ± 0.97 mm (range 7.0-12.5 mm). There was no statistically significant correlation between aUCI and umbilical cord thickness (P = .1164). Conclusions. An aUCI, or umbilical coiling pattern, does not correlate with umbilical cord thickness. It appears that a lesser amount of the umbilical supportive tissue, mainly Wharton jelly, is not related to an increased umbilical cord coiling pattern.

The Sonographic Umbilical Cord Coiling in Late Second Trimester of Gestation and Perinatal Outcomes

“…This is in agreement with the studies reported by Predanic et al that the UCI is not associated with the thickness of umbilical cord or fetal weight 16. Also this is in agreement with the study reported by Degani et al that the UCI was not associated with the umbilical arterial Doppler index 5.…”

Ultrasound Evaluation of the Amount of Wharton’s Jelly and the Umbilical Coiling Index

“…Predanic and Perni [22] evaluated the relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the 2nd trimester of pregnancy. They reported that the UCI or umbilical coiling pattern did not correlate with umbilical cord thickness.…”

Antenatal umbilical cord parameters and perinatal outcome

“…Some have shown an association between UCI and SGA, but did not find any correlation between UCI and a low 5-min Apgar score, not even with SGA by some. 2,12 Most of the pregnancies with polyhydramnios in the present report had had umbilical cord with hypercoiling (3 of 5; 60%; p=0.002). The basis for this association could be that twisting of the umbilical cord is a result of the rotary movement imparted to the embryo, probably increased liquor amnii promotes more rotary movement of the foetus resulting in more coiling.…”

“…There is some evidence that adverse antenatal and perinatal events could be predicted and/or evaluated by cord thickness and amount of Wharton's jelly, lack of or excess cord coiling, and umbilical vein blood flow patterns. 2 The umbilical cord is prone to compression or torsion with ensuing interruption of blood flow. It has been accepted that coiling provides protection against these stressors, therefore providing uninterrupted blood supply to the fetus.…”