UMBILICAL COILING INDEX AND ITS RELATIONSHIP WITH PERINATAL OUTCOMES

Aim: To evaluate any adverse perinatal outcomes associated with abnormal coiling of umbilical cord.

Introduction:The primary objective of antenatal and intrapartum fetal surveillance both in early and late pregnancy is to prevent fetal death. One of the most important parts of the fetoplacental unit is the umbilical cord. It is now being studied in predicting the perinatal outcome.

Materials and methods: This prospective study was conducted in Obstetrics and gynaecology department of a tertiary care hospital in Smt. Kashibai navale medical college and general hospital Narhe, Pune.Three hundred and fifty (350) umbilical cords of babies delivered either by vaginally or by lower segment caesarian section were examined. The umbilical coiling index was calculated by dividing the total number of coils by the length of the cord in cms. Subjects with umbilical coiling index below 10th percentile, between 10th and 90th percentile and above 90th percentile were defined as hypocoiled, normocoiled and hypercoiled respectively. It was then correlated with the following pregnancy outcomes: mode of delivery, preterm delivery, birth weight, meconium staining, Apgar score at 1 and 5 minutes, and neonatal intensive care unit (NICU) admissions. Hypocoiled cords were those having umbilical cord coiling index (UCI) less than 10th percentile and hypercoiled cords were those having UCI >90th percentile Statistical analysis was done . The results were statistically analysed by chi-square test. The p value ≤ 0.05 was considered statistically significant for all the analyses.

Result: The mean UCI was 0.61 ± 0.16. The hypocoiled umbilical cords (UCI < 10th percentile) were significantly associated with low birth weight, meconium staining, low Apgar score at 1 minute, and increased NICU admissions with a p-value < 0.05.

Conclusion:Abnormall UCI(hypocoiling) are significantly associated with adverse perinatal outcome.