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Umbilical Coiling Index Assessment During Routine Fetal Anatomic Survey: A Screening Tool for Fetuses at Risk

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Abstract

Background

The umbilical cord is the lifeline of the foetus as it supplies water, nutrients, and oxygen. Protection of these blood vessels is needed and provided by Wharton’s Jelly, amniotic fluid and the helical pattern, or coiling, of the umbilical cord vessels.

Aim

To establish the relationship between antenatal umbilical cord coiling index (aUCI) measured at 18–20 weeks along with level II USG and adverse perinatal outcomes.

Methods

A cross-sectional study was conducted on 408 antenatal women, enrolled at the time of fetal anatomic survey, and their cord coiling index (aUCI) was measured, and its association with perinatal outcomes was observed. Umbilical coiling index was classified as Hypocoiled if UCI <10th percentile, hypercoiled >90th percentile, normocoiled between 10th and 90th percentile.

Results

408 antenatal women were enrolled for the study. Mean aUCI was 0.43 ± 0.30 (normocoiled group), 0.18 ± 0.4 (hypocoiled), and 0.53 ± 0.05 (hypercoiled group). The average gestational age at delivery in hypocoiled group was 36.8 ± 2.34 weeks, and it was shorter than 38.3 ± 1.82 weeks of the normocoiled group and 38.9 ± 1.72 weeks of the hypercoiled group. Mean birth weight observed was 2055 ± 744 (hypocoiled group), 3049 ± 564 (hypercoiled), and 3102 ± 564 (normocoiled) p < 0.001. Preterm births 52 (59%) and low birth weight 76 (69%) were significantly associated with hypocoiling.

Conclusion

Abnormal umbilical cord coiling index, detected at the fetal ultrasound anatomic survey in the second trimester (18–20 weeks), can be used potentially as a screening or as a predictive tool for adverse antenatal or perinatal events.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi, 110095, India

    Richa Sharma, Gita Radhakrishnan & Shilpa Singh

  2. Department of Radiodiagnosis, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi, 110095, India

    Smita Manchanda

Authors
  1. Richa Sharma
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  2. Gita Radhakrishnan
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  3. Smita Manchanda
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  4. Shilpa Singh
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Corresponding author

Correspondence to Richa Sharma.

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Conflicts of interest

All the authors declare that they have no conflict of interest.

Ethical Statements

Prior ethical clearance was obtained from Institutional Ethical Committee—Human Research of our institution.

Additional information

Richa Sharma is an Assistant Professor in the Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi; Gita Radhakrishnan is a Director Professor in the Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi; Smita Manchanda is an Assistant Professor in the Department of Radiodiagnosis, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi; Shilpa Singh is a Senior Resident in the Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi.

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Sharma, R., Radhakrishnan, G., Manchanda, S. et al. Umbilical Coiling Index Assessment During Routine Fetal Anatomic Survey: A Screening Tool for Fetuses at Risk. J Obstet Gynecol India 68, 369–375 (2018). https://doi.org/10.1007/s13224-017-1046-8

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  • DOI: https://doi.org/10.1007/s13224-017-1046-8

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