"Coils &amp; Kinks": A Novel Technique to Evaluate the Perinatal Outcome

Razak, Khizer; Meena, Durga Shankar; Meena, G. L.

doi:10.4172/2161-0932.1000457

Cited by 3 publications

(4 citation statements)

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“…Razak and his colleagues (14) disagree in part with our study results, as they discovered that hypercoiling was substantially correlated with alcohol stained with meconium. However, their sample size was smaller than ours, and they measured UCI at 18-24 weeks while we measured it at 28-40 weeks.…”

Section: Discussioncontrasting

confidence: 99%

“…However, this can be attributed to different studies' designs where they studied directly the correlation between abnormal UCI and different adverse outcomes, this was done by addressing cases as "abnormal UCI" and controls as "normal UCI", and this greatly differs from ours. Razak and his colleagues (14) stated that hypo-coiled cords were associated with higher number of LBW babies while Tripathy (15) stated that hyper-coiled cords were associated with LBW. Tahmasebi and his colleagues (16) showed no significant association of abnormal UCI with birth weight.…”

Section: Discussionmentioning

confidence: 99%

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Antenatal Umbilical Coiling Index as a Predictor of NICU Admission as Fetal Adverse Outcome Using Color Doppler in the third trimester-A Nested Case Control Study

2023

The Egyptian Journal of Hospital Medicine

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Background: The umbilical cord is extremely important for the developing foetus because it transports deoxygenated blood to the placenta through two umbilical arteries and supplies the foetus with oxygenated blood through the umbilical vein. Umbilical cord coiling increases the chord's flexibility and tensile strength, while also offering resistance to outside pressures that might interrupt the fetus's blood supply. Objective: To determine the correlation between antenatal umbilical coiling index (UCI) and neonatal intensive care unit (NICU) admission as a fetal adverse outcome using color Doppler. Methodology: This nested case-control study was conducted on pregnant women attending to Ain Shams University Maternity Hospital Outpatient Department Ultrasound Clinics for antenatal care during the period from May 2021 until December 2022. Results: Regarding coiling index, it was statistically significantly higher among cases of NICU group compared to controls (0.53 ± 0.14 vs. 0.48 ± 0.11). There was a statistically significant higher frequency of hypercoiling in NICU group compared to non-NICU group. Regarding umbilical artery resistance index (URI), our study revealed that it was statistically significantly higher among cases of NICU group compared to control one (0.64 ± 0.08 vs. 0.60 ± 0.04). URI and UCI (< 75%) were unreliable in predicting NICU admission; AUC (area under the curve) was 71% for URI and 65% for UCI. On the other hand, URI was reliable in predicting hyper-coiling (as an indicator of adverse outcome) P<0.0001 and AUC was 77. The best cut-off value of URI was 0.61 with a sensitivity of 77%, specificity of 56%, PPV of 64% and NPV of 71% with a diagnostic accuracy of 66%. Women whose neonates have been admitted to NICU showed significantly higher rates of CS, low APGAR score and preterm labor when compared to women whose neonates have not (p<0.05). Conclusion: Umbilical coiling index was positively correlated with umbilical artery resistance index, denoting that hyper-coiling correlates with increased resistance to blood flow in the umbilical cord, but there was no statistical evidence of using UCI as predictor of NICU admission in the current study. Umbilical cord coiling may be used as a simple method to detect placental insufficiency as it positively correlated with the umbilical artery RI even without using color Doppler.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antenatal Umbilical Coiling Index as a Predictor of NICU Admission as Fetal Adverse Outcome Using Color Doppler in the third trimester-A Nested Case Control Study

2023

The Egyptian Journal of Hospital Medicine

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“…A study conducted by Razak K et al stated that hypocoiled cords were associated with more number of low birth weight babies. 16 On the contrary, Tripathy et al stated that hypercoiled cords were associated with low birth weight. 17 Tahmasebi et al showed no significant association of AUCI with birth weight which was similar to the present study.…”

Section: Resultsmentioning

confidence: 99%

Antenatal umbilical cord coiling index as a predictor of pregnancy outcome

Aanandini¹,

John

Rathod³

2021

IJOGR

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: Fetal compromise as a major contributor to neonatal morbidity is of great concern for obstetricians. Antenatal risk assessment profiles are often insufficient in picking up these cases and hence need to be improved. Antenatal Umbilical cord Coiling Index (AUCI) is one such potential predictor which helps in identifying pregnant women who need close antepartum and intrapartum monitoring. It is determined by ultrasonogram antenatally and noted to be fixed throughout the pregnancy. This study aims at determining the association between AUCI and pregnancy outcome.: This was a hospital based prospective analytical study conducted in a tertiary care centre in Pondicherry from January 2019 to May 2020. 207 pregnant women were included in the study and Colour doppler was performed and AUCI was noted. Participants were followed until delivery and pregnancy outcomes were noted.: Chi square and Fischer exact test: In the present study, among 207 subjects, 166 had normal AUCI i.e., 0.41 to 0.61. Hypocoiling was noted in 20 (< 0.41) and hypercoiling in 21(>0.61) subjects. Hypocoiling was associated with hypertension and oligohydramnios in10% cases each. Nonreasssuring fetal (NRFHR) heart rate, meconium stained liquor and low APGAR values were present in 15, 20 and 10% cases respectively. Hypercoiling was associated with diabetes (10%), hypertension (5%), oligohydramnios (10%), polyhydramnios (5%), NRFHR (10%) and meconium stained liquor (5%). However, there was no statistical significance among the above mentioned parameters.

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“…28 boses. 29,30 Indeed, over-coiling alone, even in the absence of cord stricture, has been documented at autopsy in 23% of intrauterine fetal deaths. 31 An initial low Apgar (<7 at 5 minutes) was significantly associated with both hypocoiled and hypercoiled UCI (compared to those with normocoiled groups) in our study, a result similar was reported by Gupta et al and Kashanian et al de Laat et al (2006) in their study of 885 cases, found that low Apgar scores was associated with hypocoiled group, as in other studies.…”

Section: Strong Et Al (1993) Andmentioning

confidence: 99%

Umbilical Coiling Index and Its Relation to Perinatal Outcome

Devi¹,

Ramesh²,

Naik³

et al. 2021

J Clin Obstet Gynecol

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Umbilical cord is crucial to the development, well-being and survival of the fetus, but also being vulnerable to kinking, compressions, traction, and torsion which may affect the perinatal outcome. Abnormally coiled cords have been reported to be more frequent in cases with adverse perinatal outcome. It was aimed to evaluate the umbilical coiling index (UCI) postnatally and its association with perinatal morbidity and mortality. Material and Methods: We conducted a cross sectional study for over 12 months in ESIC MC & PGIMSR, Bengaluru. A total of 321 term consenting parturient mothers with singleton live pregnancy in cephalic presentation were randomly selected by a single observer admitted in labour room irrespective of their parity. After delivery, the UCI was calculated as the number of complete coils divided by the total length of the cord in centimetres, UCI was grouped as hypocoiled (<10 th percentile), normocoiled (10 th to 90 th percentile) and hypercoiled (>90 th percentile). The statistical tests used were chi-square test and Fisher exact test in SPSS v24, p value of less than 0.05 was taken as statistically significant. Results: The mean UCI was 0.18 +/-0.096. Of the patients, 9.3% (30 out of 321) had hypocoiled (UCI<0.082) and 9.7% (31 patients) had hypercoiled (UCI>0.316). Hypercoiled is significantly associated with fetal distress [OR=13.5 (0.003-0.008)] p=0.001, neonatal intensive care unit (NICU) admission [OR=19.14 (0.01 to 0.015)] p<0.001 and meconium staining [OR=5.65 (0.024-0.030)] p=0.017. It was also found that presence of nuchal cord in hypercoiled group was significantly associated with fetal distress [OR=4.661 (0.052-0.061)] p=0.031. Conclusion: Abnormal UCI is associated with adverse perinatal outcome. Clinical significance: Antenatal detection of the coiling index can identify the fetuses at risk and thus help in timely intervention and further management.

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"Coils & Kinks": A Novel Technique to Evaluate the Perinatal Outcome

Cited by 3 publications

References 0 publications

Antenatal Umbilical Coiling Index as a Predictor of NICU Admission as Fetal Adverse Outcome Using Color Doppler in the third trimester-A Nested Case Control Study

Antenatal Umbilical Coiling Index as a Predictor of NICU Admission as Fetal Adverse Outcome Using Color Doppler in the third trimester-A Nested Case Control Study

Antenatal umbilical cord coiling index as a predictor of pregnancy outcome

Umbilical Coiling Index and Its Relation to Perinatal Outcome

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