ABSTRACT
Objective: Umbilical cord is crucial to the development, well-being and survival of the fetus, but also being vulnerable to kinking, compressions, traction, and torsion which may affect the perinatal outcome. Abnormally coiled cords have been reported to be more frequent in cases with adverse perinatal outcome. It was aimed to evaluate the umbilical coiling index (UCI) postnatally and its association with perinatal morbidity and mortality. Material and Methods: We conducted a cross sectional study for over 12 months in ESIC MC & PGIMSR, Bengaluru. A total of 321 term consenting parturient mothers with singleton live pregnancy in cephalic presentation were randomly selected by a single observer admitted in labour room irrespective of their parity. After delivery, the UCI was calculated as the number of complete coils divided by the total length of the cord in centimetres, UCI was grouped as hypocoiled (<10th percentile), normocoiled (10th to 90th percentile) and hypercoiled (>90th percentile). The statistical tests used were chi-square test and Fisher exact test in SPSS v24, p value of less than 0.05 was taken as statistically significant. Results: The mean UCI was 0.18 +/- 0.096. Of the patients, 9.3% (30 out of 321) had hypocoiled (UCI<0.082) and 9.7% (31 patients) had hypercoiled (UCI>0.316). Hypercoiled is significantly associated with fetal distress [OR=13.5 (0.003-0.008)] p=0.001, neonatal intensive care unit (NICU) admission [OR=19.14 (0.01 to 0.015)] p<0.001 and meconium staining [OR=5.65 (0.024-0.030)] p=0.017. It was also found that presence of nuchal cord in hypercoiled group was significantly associated with fetal distress [OR=4.661 (0.052-0.061)] p=0.031. Conclusion: Abnormal UCI is associated with adverse perinatal outcome. Clinical significance: Antenatal detection of the coiling index can identify the fetuses at risk and thus help in timely intervention and further management.