Evaluation of Umbilical Cord Coiling Index in late second trimester and its association with Perinatal Outcome
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2016, Vol 3, Issue 3
Abstract
Background: Umbilical cord plays a major role for foetal persistence during the intrauterine period. Reports had shown that abnormal umbilical cord coiling in the form of hypo or hypercoiling are associated with abnormal foetal outcome in the form of chromosomal disorders, intra-uterine deaths, growth retardation, meconium stained liquor, abnormal foetal heart rate and chorioamnionitis. Aim: To evaluate the association between umbilical cord coiling index in the 2nd trimester and the perinatal outcome among the registered antenatal mothers. Methodology: A prospective longitudinal study was conducted at the Institute of Obstetrics and Gynecology, Egmore Chennai for a period of one year between June 2012 to May 2013. A total of 385 women were recruited for the study. A semi-structured questionnaire was used for collecting the demographic details. The coiling index was measured using 3.5 MHz transabdominal transducer. Longitudinal images of the umbilical cord were taken, part of the cord which was freely floating in the amniotic fluid was taken, and the coiling index was calculated. Coiling index of less than the 10th percentile was considered as hypocoiled and above 90th percentile was considered as hypercoiled. Results: The increase in the age of the mothers had shown a strong association in the development of abnormal umbilical coiling and the majority of the mothers with hypocoiled umbilical cord had delivered in less than 37 weeks of gestational age. The incidence of pregnancy induced hypertension and gestational diabetes mellitus had shown a statistically strong association with hypocoiled umbilical cord (p<.05). Mothers with hypercoiled umbilical cord had a strong association in the development of abnormal cardiotocography (p<.05) and meconium stained liquor and their foetal parameters like abnormal APGAR score and development of foetal distress were found to be more common. Conclusion: Abnormal umbilical cord index had shown a strong association with adverse antenatal and neonatal events.
Authors and Affiliations
Gayatri Najarajan, Senthil Priya Sundaram, Shankar Radhakrishnan, Allirathnam Allirathnam
Keywords
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