Antenatal ultrasound assessment of the umbilical coiling index as an imaging marker of adverse perinatal outcomes: a hospital-based prospective observational cohort study.
DOI:
https://doi.org/10.51168/cnan3910Keywords:
Umbilical coiling index, Antenatal ultrasound, Perinatal outcome, Fetal distress, Hypocoiling, Obstetric imagingAbstract
BackgroundThe helical arrangement of umbilical vessels protects fetoplacental circulation by providing resistance to compression and torsion. Abnormal umbilical coiling patterns have been associated with adverse perinatal outcomes. This study evaluated the role of the Umbilical Coiling Index (UCI) as an antenatal imaging marker of fetal compromise.
Methods
This hospital-based prospective observational cohort study included 181 singleton pregnancies beyond 28 weeks of gestation conducted at Karpagam Institute of Medical Sciences and Research, Coimbatore, India, between May 2023 and May 2025. Based on antenatal UCI assessment, pregnancies were categorized as normocoiled (n=95), hypocoiled (n=53), and hypercoiled (n=33). Maternal, intrapartum, and neonatal outcomes were compared among the groups.
Results
Hypocoiled cords showed significantly higher rates of preterm labour (38%, p=0.006), fetal heart rate deceleration (45%, p=0.001), and low 5-minute Apgar scores (13%, p=0.036) compared with normocoiled and hypercoiled cords. The hypocoiled group also demonstrated the lowest mean cord pH (7.074), indicating a trend toward fetal acidosis, although this was not statistically significant (p=0.067). Meconium-stained liquor was more frequent in hypercoiled cords but did not differ significantly among groups (p=0.687).
Conclusion
The antenatal Umbilical Coiling Index is a simple and reproducible sonographic biomarker that may improve risk stratification during routine obstetric ultrasound, particularly for identifying fetuses at risk of intrapartum compromise and adverse neonatal outcomes.
Recommendation
Routine incorporation of UCI assessment into structured obstetric ultrasound reporting.
References
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2. Rana J, Ebert GA, Kappy KA. Adverse perinatal outcome in patients with an abnormal umbilical coiling index. Obstet Gynecol. 1995;85(4):573-7. https://doi.org/10.1016/0029-7844(94)00435-G
3. Predanic M, Perni SC, Chasen ST, Baergen RN, Chervenak FA. Sonographic assessment of the umbilical cord coiling index and adverse pregnancy outcome. J Ultrasound Med. 2005;24(2):185-91. https://doi.org/10.7863/jum.2005.24.2.185
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Copyright (c) 2026 Dr. M. Deyananda Chakravarthy, Dr. Valarmathi, Dr. Divyapriya S (Author)
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