UMBILICAL COILING INDEX AS A MARKER OF PERINATAL OUTCOME

Abstract

Beenakumari R1, Ramya M2, Kunjamma M. A3

BACKGROUND
Umbilical cord is the lifeline of the foetus, which contains three vessels in a coiled fashion. Total number of coils divided by umbilical cord length centimetres is called Umbilical Coiling Index (UCI). Abnormal umbilical coiling index has been related to adverse perinatal outcome.
MATERIALS AND METHODS
Sample Size 600.
Singleton live cephalic deliveries after 37 weeks both vaginal and caesarean section were included. Immediately after delivery, umbilical cord is clamped at 5 cm from the foetal end and cut. Length of cord is measured. No. of coils measured as one complete 360° spiral course of vessels.
At the end, mean umbilical coiling index is calculated. Normocoiled group was having UCI values between 10th and 90th percentile, hypocoiled group was having <10th percentile and hypercoiled group was having UCI >90th percentile. Outcomes measured were maternal age, meconium-stained amniotic fluid, foetal growth restriction, 5 mins. APGAR scores, neonatal intensive care unit admissions and hypoglycaemia. Statistical analysis was performed using SPSS software and chi-square test. P value of <0.05 was regarded as statistically significant.
SETTINGS AND DESIGN- Descriptive study conducted from January 2014 to June 2014 in Dept. of Obstetrics and Gynaecology, Govt. Medical College, Kottayam.
RESULTS
The mean UCI is 0.23±0.11/cm. With a minimum of 0.02/cm and maximum of 0.6/cm. UCI of hypocoiled group was <0.08 and that of hypercoiled group was >0.3. Out of 600 subject, 485 (80.8%) had normocoiling, 58 (9.7%) had hypocoiling and 57 (9.5%) had hypercoiling. 23 (40%) subjects with hypocoiling had foetal growth restriction (P value <0.05 significant) 2 large for gestational age (4%) babies had hypercoiling (P value <0.05). In the hypocoiled group, 22 (38%) had meconium-stained amniotic fluid, which was significant. There was significant association between hypocoiling and low normal amniotic fluid index, oligohydramnios, low 5’ APGAR scores and neonatal intensive care unit admission. 15 (26%) babies had hypoglycaemia in the hypocoiled group while only 7 (12%) in hypercoiled group had hypoglycaemia (P value <0.005).

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