DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204021

Study of umbilical coiling index and perinatal outcome

Sujata Singh, Swati Pai, Barsha Sahu

Abstract


Background: Study was to evaluate the relationship between umbilical coiling index (UCI) and hypo-and hyper coiling of the umbilical cord and parity, neonatal weight, Ponderal Index (PI), APGAR (Appearance, pulse, grimace, activity, and respiration) score, meconium staining of the amniotic fluid, Intrauterine growth restriction (IUGR), hypertensive disorders of pregnancy and delivery interventions.

Method: A prospective analytical study was performed from January 2017 to December 2018. Total of 300 patients giving birth at labour room of SCB Medical College, Cuttack were taken into study. Immediately following delivery, the umbilical cord was clamped at the foetal end and cut with scissors. UCI, mode of delivery and perinatal outcome was followed up.

Results: There were 149 lower segment caesarean sections accounting to 49.7% and 151 vaginal deliveries including instrumental deliveries which was accounting to 50.3%. Minimum number of coils observed was 2. The maximum number of coils observed was 50. Caesarean section was more in hypo coiling group. APGAR score at 5 min was calculated and there was a total of 109 neonates who had APGAR <7 at 5 minutes (36.33%) out of which there were 17 neonates with hypo coiling (2.33%), 77 neonates with normo-coiling (25.66%) and 15 neonates with hyper coiling (5%). Meconium staining and instrumental delivery was more associated with hyper coiling.

Conclusion: Both hyper-coiling and hypo-coiling had significant correlation with adverse perinatal outcome. If the UCI can be measured reliably in utero by ultrasound, then it might be a promising prognostic marker for adverse pregnancy outcome.


Keywords


Umbilical coiling index, Hyper-coiling, Hypo-coiling, Perinatal outcome, Meconium staining

Full Text:

PDF

References


Gupta S, MMA Faridi, J Krishnan. Umbilical coiling index. J Obstet Gynecol. 2006;56(4):315-9.

Lacro RV, Jones KL, Benirschke K. The umbilical cord twist: origin, direction and relevance. Am I obstet Gynecol. 1987;157:833-8.

Strong Jr. TH, Elliott JP, Radin TG. Non coiled umbilical blood vessel: a new marker for fetus at risk. Obst Gynecol. 1993;81(3):409-411.

Edmonds HW. The spiral twists of the normal umbilical cord in twins and in singletons. Am I obstet Gynecol. 1954;67:102-20.

Chitra T, Sushanth YS, Raghavan S. Umbilical Coiling Index as a Marker of Perinatal Outcome: An Analytical Study. Obstet Gynecol Int. 2012;2012:213689.

De Laat MW, Franx A, Var Alderen EO. The umbilical coiling index, a review of the literature. J Matern Fetal Neonatal Med. 2005;17:93-100.

Rana J, E bert GA, Kappy KA. Adverse perinatal outcome in patients with abnormal umbilical coiling index. Obstet Gynecol. 1995;85:573-7.

Van Dijk CC, Franx A, De Latt MWM. The umbilical coiling index in normal pregnancy. J Matern Fetal Neonatal Med. 2002;11:280-3.

Revathi K, Dilshath. Umbilical coiling index and its relation with adverse perinatal outcome. IJRE. 2013;12:15-17.

Strong TH, Jarles DL, Vega JS. The umbilical coiling index. Am J Obstet Gynecol. 1994;170:29-32.

Ercal T, Laun S, Altunyurt S, Saygili U, Cinar O, and Mumcu A. Umbilical coiling index: is it a marker for fetus at risk? British J Clinical Practice. 1996;50(5):254–256.

Ezhimokai M, Rizk D, Thomas L. Maternal risk factors for abnormal vascular coiling of the umbilical cord. American J Perinatology. 2000:17(8);441-446.