DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160887

Antenatal umbilical cord parameters and perinatal outcome

Athira Narayanan, Priya Ballal, Nikil Shetty, Pralhad Kushtagi

Abstract


Background: The objective of the study was to study the association between antenatally determined umbilical cord thickness and coiling index at/after 34 weeks of gestation and the measures of perinatal outcome.

Methods: Umbilical cord thickness and coiling index were determined sonographically at or after 34 weeks of gestation in 100 singleton pregnancies. The influence of the antenatal cord findings was analyzed for their associations with measures of perinatal outcome in high and low risk pregnancies. Intrapartum fetal heart rate abnormalities, meconium staining of liquor, birth weight, Apgar score and the need for neonatal intensive care (NICU) admission were considered as measures of perinatal outcome.

Results: Mean cord thickness was 1.62 ± 0.26 cm and the coiling index was 0.42 ± 0.08 in the present observation of 100 cord sonographies. There were 39 pregnancies with high risk attributes. High risk pregnancies were found to have higher proportion of cases with lean (<1.3 cm; p = 0.04) and hypercoiled cord (>0.5; p = 0.00). Among individual associations thicker cord (>1.9 cm) and macrosomia (p = 0.01), hypercoiled cord and polyhydramnios (p = 0.02) were significant. More number of primigravidas were seen to have hypercoiled cord (p = 0.04). Association between cord parameters and meconium stained amniotic fluid, low Apgar score or NICU requirement could not be established.

Conclusions: No association between antenatal umbilical cord characteristics and perinatal outcome was found in pregnancies at high risk for poor perinatal outcome.

Keywords


Umbilical cord thickness, Coiling index, Perinatal outcome, Meconium stained amniotic fluid, High risk pregnancy

Full Text:

PDF

References


Kushtagi P, Deepika KS. Amniotic Fluid Index at admission in Labor as predictor of Intrapartum Fetal Status. J Obstet Gynecol. 2011;31:393-5.

Predanic M, Perni SC. Absence of a relationship between umbilical cord thickness and coiling patterns. J Ultrasound Med. 2005;24:1491-6.

Raio L, Ghezzi F, Di Naro E, Franchi M, Maymon E, Mueller MD. Prenatal diagnosis of a lean umbilical cord : a simple marker for the fetus at risk for being small for gestational age at birth. Ultrasound Obstet Gynecol. 1999;13:176-80.

Raio L, Ghezzi F, Di Naro E, Franchi M, Bolla D, Schneider H. Altered Sonographic Umbilical Cord Morphometry in Early-Onset Preeclampsia. Obstet Gynecol. 2002;100:311-6.

Weissman A, Jakobi P, Bronshtein M, Goldstein I. Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J Ultrasound Med. 1994;13:11-4.

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

Macones GA, Hankins GD, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. J Obstet Gynecol Neonatal Nurs. 2008;37:510-5.

Edwards LE, Barrada MI, Tatreau RW, Hakanson EY. A Simplified antepartum risk-scoring system. Obstet Gynecol. 1979;54:237-40.

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;21:195-8.

Cromi A, Ghezzi F, Di Naro E, Siesto G, Bergamini V, Raio L. Large cross-sectional area of the umbilical cord as a predictor of fetal macrosomia. Ultrasound Obstet Gynecol. 2007;30:861-6.

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.

Musthafa SJ, Said AB. Association of umbilical coiling index in normal and complicated pregnancies. Diyala Journal of Medicine. 2013;5:15-22.