Mittal Ankita, Nanda Smiti, Sen Jyotsna
Department of Obstetrics and Gynecology, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, 124001, Haryana, India,
Arch Gynecol Obstet. 2015 Apr;291(4):763-8. doi: 10.1007/s00404-014-3456-5. Epub 2014 Sep 11.
To evaluate the relationship between sonographic measurements of umbilical cord coiling index during late second trimester of pregnancy and perinatal outcome.
This prospective study was conducted on two hundred pregnant women with uncomplicated, singleton pregnancy between 20 to 24 weeks of gestation. The antenatal umbilical coiling index (UCI) was calculated by doing a transabdominal ultrasound at the time of induction into the study as the reciprocal of the pitch of one complete vascular coil. The patients were followed up till delivery and any adverse antenatal and/or perinatal event was noted.
The mean value for the UCI was noted to be 0.36 + 0.07 coils/cm with a 95% CI of 0.35-0.37. The values for the 10th and the 90th percentile were 0.26 and 0.46 coils/cm respectively. Accordingly the cases were divided into three groups- hypocoiled (UCI <10th percentile)-18, normocoiled (UCI between 10th-90th percentile)-162 and hypercoiled (UCI >90th percentile)-20. Hypocoiling was observed to be significantly associated with preterm labour pains (P value 0.0344), oligohydramnios (P value 0.0021), intrapartum foetal heart rate abnormalities (P value 0.0012), instrumental vaginal delivery (P value 0.0275) and low birth weight (P value 0.0344). Hypercoiling was found to be significantly associated with intrauterine growth restriction (P value 0.0323), foetal heart rate abnormalities during labour (0.0399) and low birth weight (P value 0.0095).
Abnormal umbilical coiling index in the form of either hypo- or hypercoiling is associated with several adverse antenatal and neonatal outcomes.
评估妊娠中期晚期脐带盘绕指数的超声测量值与围产期结局之间的关系。
本前瞻性研究针对200例妊娠20至24周、单胎妊娠且无并发症的孕妇进行。在纳入研究时通过经腹超声计算产前脐带盘绕指数（UCI），作为一个完整血管盘绕节距的倒数。对患者进行随访直至分娩，并记录任何不良产前和/或围产期事件。
UCI的平均值为0.36±0.07圈/厘米，95%置信区间为0.35 - 0.37。第10百分位数和第90百分位数的值分别为0. – 26圈/厘米和0.46圈/厘米。据此，病例分为三组：盘绕过少组（UCI<第10百分位数）- 18例，正常盘绕组（UCI在第10至90百分位数之间）- 162例，盘绕过多组（UCI>第90百分位数）- 20例。观察到盘绕过少与早产阵痛（P值0.0344）、羊水过少（P值0.0021）、产时胎儿心率异常（P值0.0012）、器械助产阴道分娩（P值0.0275）和低出生体重（P值0.0344）显著相关。发现盘绕过多与宫内生长受限（P值0.0323）、分娩时胎儿心率异常（0.0399）和低出生体重（P值0.0095）显著相关。
脐带盘绕指数异常，无论是盘绕过少还是过多，都与多种不良产前和新生儿结局相关。
