CORRELATION OF ANTENATAL UMBILICAL ARTERY COILING INDEX AT SECOND TRIMESTER ULTRASOUND SCAN WITH PERINATAL FETAL OUTCOME

Abstract

Aims and Objectives: To evaluate the perinatal fetal outcome in correspondence with the second-trimester scan umbilical artery coiling index in uncomplicated singleton pregnancies. Participants were recruited in the ultra Methods: sound unit at the Vani-Vilas hospital, Bangalore medical college & research institute All ultrasound examinations were performed using a 6-MHz transabdominal transducer, with multihertz and harmonic capability.The evaluation of the umbilical cord mid-segment (free loop) that included recording of longitudinal cord images for the assessment of cord coiling. The antenatal UCI was calculated as the reciprocal of the distance between a pair of coils.After calculating the UCI, perinatal factors like meconium staining, fetal weight and Apgar score were followed till discharge. For the classication of newborns as SGA, gestational age-specic centiles were used. The sensitivity, specicity, posit Results: ive predictive value (PPV), and negative predictive value (NPV) of abnormal coiling for predicting SGA were 20%, 75%, 9.8%, and 87.4%, respectively.The odds ratio (OR) for the association between abnormal coiling index versus SGA at birth was 0.7 (95% CI: 0.3–1.6, P = 0.445. There was no signicant change in the above estimate with an OR of 0.6 (95% CI: 0.32–1.4, P = 0.26). Total of 19 cases which had meconium liqour, 3 (20.0%) had normocoiling, 14 (74%) had hypocoiling, 2 (4%) had hypercoiling. 135(88.0%) cases did not have meconium stained liquor. Out of them 116(95.4%) had normocoiling, 7 (26%) had hypocoiling and 12 (96.0%) had hypercoiling, which was statistically strongly signicant with P value being <0.001 (P <0.01) is strongly signicant. Meconium staining was more in the hypocoiled group. Apgar score at 1 minute and 5 minutes of < 7 was found with UCI which was < 10th percentile. Conclusion: The abnormal umbilical coiling index is associated with adverse perinatal outcomes. UCI which is < 10th percentile is termed as hypocoiling and it is associated with meconium staining and low Apgar scores. Therefore, an antenatal detection of the coiling index can identify fetuses who are at risk and thus help in further management.