Ultrasonographic evaluation of antenatal umbilical cord coiling index (aUCI) in second trimester of gestation and pregnancy outcome
Background: To evaluate the role of antenatal umbilical cord coiling index (aUCI) obtained during routine second trimester ultrasound as a predictor of perinatal outcome.
Methods: Fetal ultrasound of 100 pregnant women was done between 18-24 weeks of gestation. Antenatal UCI was calculated as a reciprocal value of the distance between a pair of coils. Patients were followed up till delivery for perinatal outcome. UCI was correlated with: (1) gestational age (2) mode of delivery, (3) presence of meconium-stained amniotic fluid, (4) APGAR scores and (5) birth weight.
Results: aUCI was categorized as hypocoiled, normocoiled or hypercoiled. Hypocoiled cord was associated with LBW (1%), preterm delivery (1%) while hypercoiled cord was associated with LBW (4%). No statistical difference was found for birth weight, gestational age, APGAR scores and MSAF between the groups with normal and abnormal aUCI.
Conclusions: In present study, no association was found between abnormal aUCI with higher prevalence of interventional delivery, presence of MSAF, preterm and LBW. Therefore, more specific parameters need to be developed as promising prognostic marker for predicting adverse perinatal outcome and further studies are needed to test this hypothesis.
Schöni-Affolter F, Dubuis-Grieder C, Strauch E. The umbilical cord. 2007; Available at: http://www.embryology.ch/anglais/fplacenta/ cordon01.html.
Di Naro E, Ghezzi F, Raio L, Franchi M, D’Addario V. Umbilical cord morphology and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2001;96(2):150-7.
Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. (23rd ed) New York: McGraw Hill Medical; 2010.
Van den Broek N, Ntonya C, Kayira E, White S. Neilson JP. Preterm birth in rural Malawi: high incidence in ultrasound-dated population. Human Reproduct, 2005;20(11):3235-7.
Hanretty K. Obstetrics Illustrated. Edinburgh:7th Ed. Churchill Livingstone Elsevier; 2010.
Muppala H, Bedoya-Ronga A, Martindale E. Abnormally long umbilical cord with marked spiraling and true knots: a case report. Int J Gynecol Obstet. 2007;7(1):7.
ShaluGupta M, Krishnan J. Umbilical coiling index. J Obstet Gynecol India. 2006;56(4):315-9.
Strong TH Jr, Elliott JP, Radin TG. Non-coiled umbilical blood vessels: a new marker for the foetus at risk. Obstet Gynecol. 1993;81(3):409-11.
Ross JA, Jurkovic D, Zosmer N, Jauniaux E, Hacket E, Nicolaides KH. Umbilical cord cysts in early pregnancy. Obstet Gynecol. 1997;89(3):442-5.
Malpas P and Symonds EM. Observations on the structure of the human umbilical cord. Surg Gynecol Obstet 1966;123(4):746-50.
Lacro RV, Jones KL, Benirschke K. The umbilical cord twist: origin, direction, and relevance. American J Obstet Gynecol. 1987;157(4):833-8.
Strong TH Jr, Jarles DL, Vega JS, Feldman DB. The umbilical coiling index. Am J Obstet Gynecol 1994;170(1):29-32
Machin GA, Ackerman J, Gilbert-Barness E. Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Pediatr Dev Pathol 2000;3(5):462-71.
Degani S, Lewinsky RM, Berger H, Spiegel D. Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstet Gynecol 1995;86(6):990-3.
Predanic M, Perni SC, Chasen ST, Baergen RN, Chervenak FA. Assessment of umbilical cord coiling during the routine fetal sonographic anatomic survey in the second trimester. J Ultrasound Med. 2005;24(2):185-91.
Degani S, Leibovich Z, Shapiro I, Gonen R, Ohel G. Early second-trimester low umbilical coiling index predicts small-for-gestational-age fetuses. J Ultrasound Med. 2001;20:1183-8.
De Laat MW, Franx A, Nikkels PG, Visser GH. Prenatal ultrasonographic prediction of the umbilical coiling index at birth and adverse pregnancy outcome. Ultrasound Obstet Gynecol. 2006;28(5):704-9.
Qin Y, Lau TK, Rogers MS. Second-trimester ultrasonographic assessment of the umbilical coiling index. Ultrasound Obstet Gynecol. 2002;20(5):458-63.
Sharma B, Bhardwaj N, Gupta S, Gupta PK, Verma A, Malviya K. Association of Umbilical Coiling Index by Colour Doppler Ultrasonography at 18–22 Weeks of Gestation and Perinatal Outcome. J Obstet Gynaecol India. 2012;62(6):650-4.
Degani S, Leibovich Z, Shapiro I, Gonen R, Ohel G. Early second-trimester low umbilical coiling index predicts small-for-gestational-age fetuses. J Ultrasound Med. 2001;20(11):1183-8.
Tahmasebi M and Alighanbari R. Evaluation of umbilical cord thickness, cross-sectional area, and coiling index as predictors of pregnancy outcome. Indian J Radiol Imaging. 2011;21(3):195-8.
Siddiqui MA, Ahmad I, Ullah E, Khalid M, Ahmad M, Ahmad M. Prediction of adverse perinatal outcome using antenatal umblical cord coiling index. Pediatr Therapeut. 2011;1(2):79.