The sonographic umbilical cord coiling in late second trimester of gestation and perinatal outcomes

Yun Sung Jo, Dong Kue Jang, Guisera Lee, Yun Sung Jo, Dong Kue Jang, Guisera Lee

Abstract

Background: This study was conducted to determine whether or not the umbilical cord coiling index (UCI) during the late second trimester of gestation is associated with perinatal outcomes.

Methods: This was a retrospective study of 251 pregnancies in which a fetal anatomic survey with a recorded UCI was performed at 22-28 weeks gestation. The subjects were divided into normocoiled, hypocoiled, and hypercoiled groups and compared perinatal outcomes.

Results: Two hundred twenty-six patients were included. The incidence of preterm deliveries in hypocoiled group was 35%, which was significantly greater than the normocoiled groups (p=0.041). The incidence of neonates with low birth weights in the hypocoiled group was 36.4%, which was significantly greater than the normocoiled groups (p=0.044). In the hypocoiled group, 27.3% of newborns were admitted to the NICU which was significantly greater than the normocoiled and hypercoiled groups (p=0.041). After the adjustment by logistic regression analysis, only preterm delivery were significantly increased in hypocoiled group (OR=9.6, 95% CI=2.09-44.07).

Conclusion: The hyporcoiling of the umbilical cord during the late second trimester of pregnancy suggest that the risk for preterm delivery is high, consequently the delivery of low birthweight neonates is high, and the admission to the neonatal intensive care unit is increased.

Keywords: perinatal outcome; ultrasonography; umbilical cord; umbilical cord coiling.

Conflict of interest statement

Conflict of Interest: The authors have declared that no conflict of interest exists.

References

    1. Machin GA, Ackerman J, Gilbert-Barness E. Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Pediatr Dev Pathol. 2000;3:462–71.
    1. Strong THJr, Jarles DL, Vega JS, Feldman DB. The umbilical coiling index. Am J Obstet Gynecol. 1994;170:29–32.
    1. Ercal T, Lacin S, Altunyurt S, Saygili U, Cinar O, Mumcu A. Umbilical coiling index: is it a marker for the foetus at risk? Br J Clin Pract. 1996;50:254–6.
    1. Degani S, Leibovich Z, Shapiro I, Gonen R, Ohel G. Early second-trimester low umbilical coiling index predicts small-for-gestational-age fetuses. J Ultrasound Med. 2001;20:1183–8.
    1. Degani S, Lewinsky RM, Berger H, Spiegel D. Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstet Gynecol. 1995;86:990–3.
    1. Jang DG, Jo YS, Lee SJ, Kim N, Lee GS. Perinatal outcomes and maternal clinical characteristics in IUGR with absent or reversed end-diastolic flow velocity in the umbilical artery. Arch Gynecol Obstet. 2011 Jul;284(1):73–8.
    1. Kurita M, Hasegawa J, Mikoshiba T. et al. Ultrasound evaluation of the amount of Wharton's jelly and the umbilical coiling index. Fetal Diagn Ther. 2009;26:85–9.
    1. Kwon JY, Jo YS, Lee GS, Kim SJ, Shin JC, Lee Y. Cervical dilatation at the time of cesarean section may affect the success of a subsequent vaginal delivery. J Matern Fetal Neonatal Med. 2009;22:1057–62.
    1. Nam SW, Jo YS, Eun JW. et al. Identification of large-scale characteristic genes of Mullerian inhibiting substance in human ovarian cancer cells. Int J Mol Med. 2009;23:589–96.
    1. Edmonds HW. The spiral twist of the normal umbilical cord in twins and in singletons. Am J Obstet Gynecol. 1954;67:102–20.
    1. Cromi A, Ghezzi F, Durig P, Di Naro E, Raio L. Sonographic umbilical cord morphometry and coiling patterns in twin-twin transfusion syndrome. Prenat Diagn. 2005;25:851–5.
    1. de Laat MW, Nikkels PG, Franx A, Visser GH. The Roach muscle bundle and umbilical cord coiling. Early Hum Dev. 2007;83:571–4.
    1. Predanic M, Perni SC, Chasen ST, Baergen RN, Chervenak FA. Ultrasound evaluation of abnormal umbilical cord coiling in second trimester of gestation in association with adverse pregnancy outcome. Am J Obstet Gynecol. 2005;193:387–94.
    1. De Laat MW, Franx A, Nikkels PG, Visser GH. Prenatal ultrasonographic prediction of the umbilical coiling index at birth and adverse pregnancy outcome. Ultrasound Obstet Gynecol. 2006;28:704–9.
    1. Nishio J, Nakai Y, Mine M, Imanaka M, Ogita S. Characteristics of blood flow in intrauterine growth-restricted fetuses with hypercoiled cord. Ultrasound Obstet Gynecol. 1999;13:171–5.
    1. Predanic M, Perni SC. Absence of a relationship between umbilical cord thickness and coiling patterns. J Ultrasound Med. 2005;24:1491–6.

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