Prospective evaluation of umbilical coiling index as predictor of pregnancy outcome

Background

The umbilical coiling index (UCI) reflects the degree of vascular coiling within the umbilical cord and mayprovide useful information regarding fetal and neonatal well-being. Abnormal coiling, including hypo- and hypercoiling, hasbeen associated with adverse pregnancy outcomes. The objective is to evaluate the antenatal umbilical coiling index anddetermine its association with pregnancy and neonatal outcomes, including gestational age at delivery, mode of delivery,fetal heart-rate pattern, birth weight, meconium-stained liquor and NICU admission. Materials and Methods: A prospectiveobservational study was conducted among 130 pregnant women who fulfilled the study criteria. Antenatal ultrasonographywas used to assess the umbilical coiling pattern, and participants were categorized as normocoiled, hypocoiled orhypercoiled. Pregnancy and neonatal outcomes were subsequently assessed and compared between the three groups.Results: Normocoiling was observed in 78 (60.0%), hypocoiling in 27 (20.8%), and hypercoiling in 25 (19.2%) pregnancies,with a mean UCI of 0.39. Maternal age was significantly associated with coiling pattern (p=0.0095), as was gestational ageat delivery (p<0.00001). Mode of delivery (p=0.00011) and fetal heart-rate pattern (p<0.00001) also showed significantassociations. Meconium-stained liquor occurred in 12.8%, 7.4% and 40.0% of normocoiled, hypocoiled and hypercoiledpregnancies, respectively (p<0.00001). Mean birth weight was 2.98±0.321, 2.37±0.647 and 2.92±0.480 kg, respectively.NICU admission occurred in 3.84%, 18.51% and 28.0% of the three groups (p=0.00006).