Umbilical Coiling Index: Is It a Marker for the Foetus at Risk?

Abstract

SUMMARY The aim of this study was to determine the relationship between the number of coils in the umbilical cord and perinatal outcome. The umbilical cords and delivery records of 147 liveborn neonates were prospectively studied. The umbilical coiling index (UCI) of each cord was calculated by dividing the total number of complete umbilical vascular coils by the umbilical cord length. Subjects with UCIs below the 10th percentile, above the 90th percentile, and between the 10th and 90th percentiles were defined as hypocoiled, hypercoiled, and normocoiled, respectively. Several different parameters were used to measure neonatal outcome. The mean UCI was 0.20 ± 10 (SD). No relationship was noted between UCI and maternal age, gravidity, parity, oligohydramnios, or birth weight. When we compared the hypocoiled group (n=30) with the normocoiled group (n=87), we detected a statistically significantly higher incidence of meconium staining, interventional delivery, apgar scores, fetal blood pH and intrapartum fetal heart rate disturbances. As a result, we concluded that the UCI has a strong relationship with perinatal outcome and may be used antenatally as a marker for identifying the fetus at risk.

Role of 2‐Dimensional Ultrasound Imaging in Placental and Umbilical Cord Morphometry: Literature and Pictorial Review

“…An abnormal umbilical cord coiling index measured after delivery (postnatal coiling index) has been associated with adverse pregnancy outcomes, 13,60,61 but currently available evidence suggests poor reliability to measure the antenatal coiling index and poor sensitivity with its use to predict the postnatal coiling index. 12,58,59,62 This limits its use currently in clinical settings, including in our unit.…”

“…Umbilical cord abnormalities are a lean or thick cord diameter and hypocoiling or hypercoiling of the umbilical cord. Adverse pregnancy outcomes associated with umbilical cord abnormalities include SGA neonates and assisted delivery, including cesarean delivery …”

“…include SGA neonates 10,11 and assisted delivery, including cesarean delivery. [10][11][12][13] Timely detection of high-risk pregnancies is a priority for antenatal care. Placental and umbilical cord abnormalities are usually diagnosed after delivery, excluding the possibility of prenatal intervention, and thus had previously gained little attention from obstetricians.…”