Publication:

Association between umbilical cord coiling index and adverse perinatal outcomes: a prospective observational study

Background The umbilical cord coiling index (UCI) has been proposed as a valuable parameter in predicting adverse perinatal outcomes. Abnormal coiling patterns, including hypocoiling and hypercoiling, are thought to reflect aberrant vascular development, potentially resulting in compromised fetal well-being. Objectives were to determine the association between UCI patterns (normocoiling, hypocoiling, and hypercoiling) and maternal and neonatal outcomes in singleton pregnancies.

Methods A prospective observational study was conducted from November 2023 to November 2024 at a tertiary care center. A total of 250 pregnant women with singleton pregnancies beyond 28 weeks of gestation were enrolled. Postnatally, UCI was calculated by dividing the number of complete vascular coils by the total cord length in centimeters. Values below the 10th percentile were labeled hypocoiled ( 0.4). Outcomes, including mode of delivery, birth weight, meconium-stained liquor, APGAR scores, NICU admissions, and maternal risk factors, were analyzed.

Results Out of 250 cases, 199 (79.6%) showed normocoiling, 26 (10.4%) had hypocoiling, and 25 (10%) exhibited hypercoiling. Hypercoiled cords were significantly associated with preterm delivery 11 (44%), very low birth weight 10 (40%), NICU admission 15 (60%), and low APGAR scores at 1 and 5 minutes is 20 (80%) and 13 (52%) respectively. Hypocoiled cords showed a strong association with meconium-stained liquor 15 (57.7%) and high cesarean delivery rates 22 (84.6%). Maternal comorbidities did not show statistically significant differences among the groups.

Conclusions Both hypocoiled and hypercoiled umbilical cords are significantly associated with adverse perinatal outcomes. UCI serves as a useful postnatal marker and has potential as a prenatal predictive tool for identifying fetuses at risk.