Re-evaluation of umbilical cord coiling index in adverse pregnancy outcome - Does it have role in obstetric management?

Autor:	Singireddy N; Department of Obstetrics and Gynecology, Dr. DY Patil Vidyapeeth, Pune 411018, India., Chugh A; Department of Obstetrics and Gynecology, Dr. DY Patil Vidyapeeth, Pune 411018, India., Bal H; Department of Obstetrics and Gynecology, Dr. DY Patil Vidyapeeth, Pune 411018, India., Jadhav SL; Department of PSM, Dr. DY Patil Vidyapeeth, Pune 411018, India.
Jazyk:	angličtina
Zdroj:	European journal of obstetrics & gynecology and reproductive biology: X [Eur J Obstet Gynecol Reprod Biol X] 2023 Dec 06; Vol. 21, pp. 100265. Date of Electronic Publication: 2023 Dec 06 (Print Publication: 2024).
DOI:	10.1016/j.eurox.2023.100265
Abstrakt:	Introduction: The placenta with the umbilical cord is a vital link between the mother and fetus. Umbilical cord supplies water, nutrients and oxygen from the mother to the fetus. The most unique character of the umbilical cord is its coiling, where the contents of the cord course in a coiled helical fashion. The umbilical coiling index(UCI) can be measured antenatally using ultrasonography. In the present study we have attempted to assess the UCI antenatally by ultrasound screening and correlate abnormal antenatal UCI with the adverse maternal and neonatal outcome of pregnancy. Aims: To study umbilical coiling index ultrasonographically and to correlate it with pregnancy outcome. Methodology: 150 antenatal cases in the second trimester of pregnancy between 22 and 28weeks of gestation attending the outpatient department were included for the study in a continuous manner and subjected to antenatal UCI measurement. The cases were followed up till delivery and various factors were noted. Results: We confirmed that maternal medical comorbidities ( gestational hypertension and anemia) have a significant correlation with abnormal umbilical cord coiling index, either hyper-coiling or hypo-coiling or both.Some studies have shown a particular adverse effect being manifested in both hypo and hypercoiling. In the present study significant correlation of abnormal coiling has been found with only anaemia and hypertension in pregnancy. The question, therefore, arises:"Does abnormal UCI have any significant role in prediction of adverse outcome in pregnancy or is it just a random association?" This study does not reflect any significant role of abnormal UCI in the prediction of adverse perinatal outcome. Hence efforts to monitor UCI in the antenatal period may not have any justification in the present scenario. The latest edition of William's Obstetrics also makes a similar comment. A population based larger study to generate cut offs for hypo and hyper coiling and finding any association between abnormal coiling and perinatal outcome may throw more light on the utility of UCI as a predictor of adverse outcome in pregnancy. Competing Interests: We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. (© 2023 The Authors.)
Databáze:	MEDLINE
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