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Updated: Jun 6, 2026
A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
Evidence-based pathology: umbilical cord coiling
1SA Pathology, Women's and Children's Hospital, North Adelaide, South Australia, Australia. yee.khong@adelaide.edu
Insights
The umbilical cord coiling index may not be evidence-based due to inconsistent calculations and definitions. This impacts the reliability of pathology test results for umbilical cord abnormalities.
Area of Science:
- Pathology
- Obstetrics
- Perinatology
Background:
- Pathology test results require reproducible and clinically relevant criteria for evidence-based practice.
- The umbilical cord coiling index is a commonly used metric in obstetrics.
Purpose of the Study:
- To deconstruct the umbilical cord coiling index and assess its evidence base.
- To identify factors that may cause the umbilical cord coiling index to deviate from evidence-based standards.
Main Methods:
- Systematic review of publications on umbilical cord coiling.
- Analysis of methods for calculating the umbilical coiling index.
- Evaluation of definitions for abnormal coiling and construction of reference ranges.
Main Results:
- Inconsistencies exist in the calculation of the umbilical coiling index.
- Definitions of abnormal umbilical cord coiling lack standardization.
- Reference ranges for hypocoiling and hypercoiling do not account for measurement errors or gestational age.
Conclusions:
- The generation of the umbilical cord coiling index may be compromised by measurement errors and inconsistent definitions.
- Critical analysis of the evidence base for numerical pathology test results, like the umbilical coiling index, is necessary.
- Ensuring reproducibility and minimizing errors are crucial for evidence-based pathology testing.
Abstract:
The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.
