Umbilical cord coiling index and perinatal outcome

Area of Science:

• Perinatal Medicine
• Obstetrics
• Fetal Development

Background:

• The umbilical cord's coiling pattern is a significant morphological feature.
• Abnormal coiling, specifically hypercoiling and hypocoiling, has been anecdotally linked to poor perinatal outcomes.
• Quantifying the umbilical cord coiling index (UCI) allows for objective assessment of coiling abnormalities.

Purpose of the Study:

• To investigate the association between abnormal umbilical cord coiling index (UCI) and various perinatal outcomes.
• To determine if hypercoiled or hypocoiled cords correlate with specific adverse events in newborns.

Main Methods:

• A prospective study involving 200 term pregnancies was conducted.
• The umbilical cord coiling index (UCI) was calculated for each participant.
• Correlations were analyzed between UCI percentiles and perinatal parameters including birth weight, Apgar score, and fetal growth restriction using Chi-square and Fisher exact tests.

Main Results:

• Hypercoiled cords (UCI >90th percentile) showed a significant association with intrauterine growth restriction (IUGR) and low ponderal indices.
• Hypocoiled cords (UCI <10th percentile) were significantly linked to meconium staining, low Apgar scores (at 1 and 5 minutes), increased Cesarean delivery (LSCS) rates, and higher NICU admissions.

Conclusions:

• Abnormal umbilical cord coiling, defined by UCI, is a predictor of adverse perinatal outcomes.
• Hypercoiled cords are associated with fetal growth restriction and low ponderal indices.
• Hypocoiled cords are linked to increased risks of meconium staining, poor Apgar scores, and neonatal intensive care unit admissions.