Subashini Gopinath, Anitha Christina, Gopinath Ganesan, Ramyathangam K
Obstetrics and Gynaecology, Annaii Medical College and Hospital, Sriperumbudur, IND.
Radiology, Panimalar Medical College Hospital and Research Institute, Chennai, IND.
Cureus. 2023 Mar 2;15(3):e35680. doi: 10.7759/cureus.35680. eCollection 2023 Mar.
Background The umbilical cord coiling index (UCI) is usually measured sonographically during antenatal follow-up and can be used to determine the fetuses at risk of adverse outcomes. Methodology UCI measured antenatally and postnatally whose correlation is studied along with the association of abnormal UCI with the adverse outcomes in terms of gestational age, intrauterine growth restriction (IUGR), intra-uterine death, birth weight, sex, neonatal intensive care unit (NICU) admission, the color of the liquor, Amniotic Fluid Index (AFI), Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score at one min and five mins and mode of delivery. All parameters are tested for significant differences among UCI and a p-value < 0.05 is considered significant. The correlation of UCI measured antenatally and postnatally is tested using the spearman correlation coefficient. Results A strong correlation is found between antenatal UCI and postnatal UCI with r 0.9. The majority of the population had normo coiling. Hyper and hypo coiling are associated risks of emergency lower segment cesarean section (LSCS). Low birth weight is seen in 88.89% of hypo coiled patients with a p-value < 0.01. The coiling index among sex is found to be insignificant with a p-value of 0.81. Meconium-Stained Liquor (MSL) is seen in 78.5% of hyper coiled patients. IUGR is found to be associated with hypo coiling as seen in 59.2% of patients with significant p-value (< 0.01). Age, gestational age, and birth weight are found to be statistically significant between various coiling indexes with p-value < 0.05. Conclusion Antenatal UCI correlates with postnatal UCI and any abnormal index found can be used as a predictor of adverse perinatal outcomes and help obstetricians to monitor continuously and put the patients at risk on prophylactic measures.
脐带缠绕指数（UCI）通常在产前随访期间通过超声测量，可用于确定有不良结局风险的胎儿。
对产前和产后测量的UCI进行研究，分析其相关性，以及异常UCI与不良结局在胎龄、宫内生长受限（IUGR）、宫内死亡、出生体重、性别、新生儿重症监护病房（NICU）入院情况、羊水颜色、羊水指数（AFI）、1分钟和5分钟时的外观、脉搏、 grimace、活动和呼吸（APGAR）评分以及分娩方式等方面的关联。对所有参数进行UCI之间的显著差异检验，p值<0.05被认为具有显著性。使用斯皮尔曼相关系数检验产前和产后测量的UCI的相关性。
产前UCI与产后UCI之间存在强相关性，r为0.9。大多数人群脐带缠绕正常。过度缠绕和缠绕不足与急诊下段剖宫产（LSCS）相关。88.89%的缠绕不足患者出生体重低，p值<0.01。性别之间的缠绕指数无显著性差异，p值为0.81。78.5%的过度缠绕患者羊水粪染。发现IUGR与缠绕不足相关，59.2%的患者具有显著p值（<0.01）。不同缠绕指数之间的年龄、胎龄和出生体重在统计学上具有显著性差异，p值<0.05。
产前UCI与产后UCI相关，发现的任何异常指数都可作为围产期不良结局的预测指标，帮助产科医生持续监测并对有风险的患者采取预防措施。
