Abstract
Objectives. To measure umbilical coiling index (UCI) postnatally and to study the association of normocoiling, hypocoiling and hypercoiling to maternal and perinatal outcome. Method(s). One thousand antenatal women who went into labour were studied and umbilical coiling index calculated at the time of delivery. UCI was determined by dividing the total number of coils by the total umbilical cord length in centimeters. Its association with various maternal and perinatal risk factors were noted. The statistical tests were the Chi-square test and assessed with SPSS version 13.0 software and statistically analyzed. P value of less than 0.05 was regarded as statistically significant. Results. The mean umbilical coiling index was found to be 0.24 ± 0.09. Hypocoiling (<0.12) was found to be significantly associated with hypertensive disorders, abruptio placentae, preterm labour, oligohydramnios, and fetal heart rate abnormalities. Hypercoiling (>0.36) was found to be associated with diabetes mellitus, polyhydramnios, cesarean delivery, congenital anomalies, and respiratory distress of the newborn. Conclusion. Abnormal umbilical coiling index is associated with several antenatal and perinatal adverse features.
Highlights
Umbilical cord is vital to the development, well-being, and survival of the fetus, yet this is vulnerable to kinking, compressions, traction, and torsion which may affect the perinatal outcome
There was no association found between umbilical coiling index (UCI) and risk factors such as parity, anaemia, Rh status, heart disease, and infertility
No significant association was found between UCI and premature rupture of membranes (PROM), prolonged pregnancy, placentas praevia, epilepsy, and chorioamnionitis (Table 3)
Summary
Umbilical cord is vital to the development, well-being, and survival of the fetus, yet this is vulnerable to kinking, compressions, traction, and torsion which may affect the perinatal outcome. The umbilical cord is protected by Wharton’s jelly, amniotic fluid, helical patterns, and coiling of vessels. The origin of umbilical cord coiling is unknown. Of the many characteristics of the human umbilical cord, a most mysterious and intriguing one is the twisted or spiral course of its component blood vessels. Speaking, the vessels of the cord are wound as cylindrical helices, rather than spirals, but both terms are used interchangeably to avoid confusion [1]. The coiling of the umbilical vessels develops as early as 28 days after conception and is present in about 95% of fetuses by 9 weeks of conception. The helices may be seen by ultrasonographic examination as early as during the first trimester of pregnancy [2]
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