Umbilical Coiling Index as a Marker of Perinatal Outcome

AIM To correlate the importance of patterns of umbilical coiling in terms of umbilical coiling index with various fetal parameters in a 2 year study period. OBJECTIVESThe present study is being done to compare the perinatal outcome with the abnormal coiling of umbilical cord with respect to umbilical coiling index. MATERIALS AND METHODS This was a prospective study which was carried out in the department of Obstetrics and Gynaecology, OSMANIA MEDICAL COLLEGE, Hyderabad, Telangana for a period of 2 years.200 patients in active labour who were admitted in labour room irrespective of their parity were selected randomly for the study. RESULTS The total number of cases studied were 200. The number of babies with birth weight less than 2.5 kg are 26 (13 %), between 2.5 3.5 kgs are 168 (84 %) and greater than 3.5 are 6 (3 %). Babies born with Apgar score at 1 minute less than 4 were 43 ( 21.5 %) and greater than 4 were 157 (78.5 %). Babies born with Apgar score at 5 minutes less than 7 were 25 ( 12.5 %) and greater than 7 were 175 (87.5 %). Out of 200 babies, 35 (17.5 %) were admitted in NICU and the rest 165 (82.5 %) were not admitted. In the study of 200 babies, 23 (11.5 %) had FGR, and 177 (88.5 %) had no FGR. Out of 200 babies in the study, 52 (26 %) had fetal distress and the rest 148 (74 %) had no fetal distress. The meconium stained liquor was found in 42 cases (21 %) and clear liquor is seen in 158 (79 %). any concentration of liquor was taken into the criteria (thin or thick). CONCLUSION UCI less than 10th percentile less than 0.06, UCI greater than 90th percentile greater than0.41. The mean length of the umbilical cord in the study was 52.87 +/- 13.49. The mean number of coils was 12.59 +/- 5.38. The mean umbilical coiling index (UCI) was 0.24 +/- 0.09 which is consistent with the previous studies. The UCI was correlated to the birth weight, APGAR score at 1 min and 5 min, NICU admissions, meconium staining, fetal distress, fetal growth restriction. HYPOCOILING ( UCI 90th percentile) is associated with low birth weights, low APGAR score at 1 minute, NICU admissions, and fetal growth restriction. It is also associated with fetal distress of the baby and also meconium staining of the liquor. Thus antenatal detection of the coiling index can identify fetus at risk and thus help in further management and timely intervention.