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Published on: January 7, 2018
Umbilical coiling index in normal and complicated pregnancies
Monique W M de Laat1, Arie Franx, Michiel L Bots
1Departments of Obstetrics, Julius Center for Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands. mdelaat@dds.nl
Obstetrics and Gynecology
|May 2, 2006
Summary
Abnormal coiling of the umbilical cord, both undercoiling and overcoiling, is linked to a higher risk of adverse pregnancy outcomes. This includes issues like fetal death, preterm birth, and low Apgar scores.
Area of Science:
- Perinatal Medicine
- Obstetrics
- Fetal Development
Background:
- The arrangement of the umbilical cord, specifically its coiling, is a crucial factor in fetal well-being.
- Deviations from normal umbilical cord coiling, termed undercoiling and overcoiling, have been an area of interest for their potential impact on pregnancy.
- Understanding these associations is vital for improving perinatal care and outcomes.
Purpose of the Study:
- To investigate the relationship between umbilical cord undercoiling and overcoiling and various adverse pregnancy outcomes.
- To quantify the risk associated with these umbilical cord abnormalities.
Main Methods:
- A cross-sectional study involving 885 patients, analyzing umbilical cords and hospital records.
- The umbilical coiling index was calculated by dividing the number of coils by cord length, with researchers blinded to pregnancy outcomes.
- Statistical analysis, including multiple logistic regression, was used to determine odds ratios and confidence intervals.
Main Results:
- Undercoiling was significantly associated with fetal death, spontaneous preterm delivery, trisomies, low Apgar scores, velamentous cord insertion, and single umbilical artery.
- Overcoiling showed associations with asphyxia, low umbilical arterial pH, small for gestational age infants, trisomies, single umbilical artery, and sinistral coiling.
- Both undercoiling and overcoiling demonstrated increased risks for specific adverse perinatal events.
Conclusions:
- Undercoiling and overcoiling of the umbilical cord are significant risk factors for adverse perinatal outcomes.
- These findings highlight the importance of assessing umbilical cord morphology in prenatal care.
- Further research may explore the mechanisms linking cord coiling abnormalities to adverse outcomes.
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