Singireddy Nikhila, Chugh Amey, Bal Himadri, Jadhav S L
Department of Obstetrics and Gynecology, Dr. DY Patil Vidyapeeth, Pune 411018, India.
Department of PSM, Dr. DY Patil Vidyapeeth, Pune 411018, India.
Eur J Obstet Gynecol Reprod Biol X. 2023 Dec 6;21:100265. doi: 10.1016/j.eurox.2023.100265. eCollection 2024 Mar.
The placenta with the umbilical cord is a vital link between the mother and fetus. Umbilical cord supplies water, nutrients and oxygen from the mother to the fetus. The most unique character of the umbilical cord is its coiling, where the contents of the cord course in a coiled helical fashion. The umbilical coiling index(UCI) can be measured antenatally using ultrasonography. In the present study we have attempted to assess the UCI antenatally by ultrasound screening and correlate abnormal antenatal UCI with the adverse maternal and neonatal outcome of pregnancy.
To study umbilical coiling index ultrasonographically and to correlate it with pregnancy outcome.
150 antenatal cases in the second trimester of pregnancy between 22 and 28weeks of gestation attending the outpatient department were included for the study in a continuous manner and subjected to antenatal UCI measurement. The cases were followed up till delivery and various factors were noted.
We confirmed that maternal medical comorbidities ( gestational hypertension and anemia) have a significant correlation with abnormal umbilical cord coiling index, either hyper-coiling or hypo-coiling or both.Some studies have shown a particular adverse effect being manifested in both hypo and hypercoiling. In the present study significant correlation of abnormal coiling has been found with only anaemia and hypertension in pregnancy. The question, therefore, arises:"Does abnormal UCI have any significant role in prediction of adverse outcome in pregnancy or is it just a random association?" This study does not reflect any significant role of abnormal UCI in the prediction of adverse perinatal outcome. Hence efforts to monitor UCI in the antenatal period may not have any justification in the present scenario. The latest edition of William's Obstetrics also makes a similar comment. A population based larger study to generate cut offs for hypo and hyper coiling and finding any association between abnormal coiling and perinatal outcome may throw more light on the utility of UCI as a predictor of adverse outcome in pregnancy.
带有脐带的胎盘是母亲与胎儿之间的重要纽带。脐带将母亲体内的水、营养物质和氧气输送给胎儿。脐带最独特的特征是其呈螺旋状盘绕，脐带内的物质以螺旋状盘绕的方式走行。产前可通过超声检查测量脐带螺旋指数（UCI）。在本研究中，我们试图通过超声筛查产前评估UCI，并将异常的产前UCI与妊娠不良的母婴结局相关联。
通过超声检查研究脐带螺旋指数，并将其与妊娠结局相关联。
连续纳入150例妊娠22至28周孕中期在门诊就诊的产前病例，进行产前UCI测量。对这些病例进行随访直至分娩，并记录各种因素。
我们证实，母亲的合并症（妊娠期高血压和贫血）与异常的脐带螺旋指数（过度螺旋或螺旋不足或两者皆有）有显著相关性。一些研究表明，螺旋不足和过度螺旋都会产生特定的不良影响。在本研究中，仅发现异常螺旋与妊娠期贫血和高血压有显著相关性。因此，问题出现了：“异常的UCI在预测妊娠不良结局中是否有任何重要作用，还是仅仅是一种随机关联？” 本研究未显示异常UCI在预测围产期不良结局中有任何重要作用。因此，在目前的情况下，产前监测UCI的努力可能没有任何依据。最新版的《威廉姆斯产科学》也有类似的评论。一项基于人群的更大规模研究，以确定螺旋不足和过度螺旋的临界值，并发现异常螺旋与围产期结局之间的任何关联，可能会更清楚地揭示UCI作为妊娠不良结局预测指标的实用性。
