Document Detail

The umbilical coiling index in complicated pregnancy.
MedLine Citation:
PMID:  16513244     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate umbilical cord coiling in pregnancies with adverse outcome. STUDY DESIGN: Umbilical cords and hospital records of 565 consecutive cases with an indication for histological examination of the placenta were studied. The umbilical coiling index (UCI) was determined as the number of complete coils divided by the length of the cord in centimeters, by an observer blinded for pregnancy outcome. Data on obstetric history and pregnancy outcome of each case were obtained from the hospital records. We calculated odds ratios and their 95% confidence interval to evaluate the strength of associations between pregnancy outcome and abnormal cord coiling. RESULTS: Fetal death (OR 4.09, 95% CI 2.22-7.55), chorioamnionitis (OR 1.77, 95% CI 1.09-2.88), fetal structural or chromosomal abnormalities (OR 1.78, 95% CI 1.08-2.95), and lower Apgar score at 5 min (p=0.03) were associated with undercoiling (UCI below the 10th percentile, using reference values from uncomplicated pregnancies). Fetal death (OR 3.74, 95% CI 1.89-7.40), iatrogenic preterm delivery (OR 1.91, 95% CI 1.04-3.49), umbilical arterial pH<7.05 (OR 3.63, 95% CI 1.44-9.17), fetal structural or chromosomal abnormalities (OR 1.79, 95% CI 1.01-3.16), thrombosis in fetal placental vessels (OR 2.64, 95% CI 1.37-5.06), chronic fetal hypoxia/ischemia (OR 1.82, 95% CI 1.09-3.05), and lower weight for gestational age (p=0.01) were associated with overcoiling (UCI above the 90th percentile). CONCLUSIONS: Our findings confirm that adverse perinatal outcome is associated with both undercoiling and overcoiling of the umbilical cord.
Monique W M de Laat; Elise D van Alderen; Arie Franx; Gerard H A Visser; Michiel L Bots; Peter G J Nikkels
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Publication Detail:
Type:  Journal Article     Date:  2006-03-02
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  130     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-22     Completed Date:  2007-04-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  66-72     Citation Subset:  IM    
Department of Obstetrics, University Medical Center KE.04.123.1, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
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MeSH Terms
Apgar Score
Fetal Death / pathology
Fetal Diseases / pathology
Obstetric Labor Complications*
Placenta / anatomy & histology*,  pathology
Pregnancy Outcome*
Premature Birth / pathology
Retrospective Studies
Torsion Abnormality / pathology
Umbilical Cord / abnormalities,  pathology*

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