بررسی ارتباط شاخص حلقه‌های بند ناف با عواقب نامطلوب پره‌ناتال

    Background & Aim: Studies have shown that umbilical coiling index(UCI) can have clinical importance. The present study was undertaken to evaluate the relation between umbilical coiling index(UCI) and adverse perinatal outcome. Patients & Methods: In this prospective cross-sectional study performed in Akbar Abadi Hospital(Tehran), between March 2003-July 2004, 699 pregnant women and their umbilical cord were evaluated. All women were 37-40 weeks of gestation with singleton and cephalic fetus. Umbilical coiling index(UCI) was determined by dividing the total number of the complete vascular coilings by total umbilical cord length centimeter. UCI under the tenth percentile(less than 0.17) was defined as hypocoiled and UCI between the tenth and ninetieth percentile(0.17-0.37) was defined as normocoiled and UCI above the ninetieth percentile(more than 0.37) was defined as hypercoiled cord. Then, the relation between UCI and maternal age, parity, neonatal weight, amniotic fluid index(AFI), meconium in amniotic fluid, maternal diabetes and hypertension, Apgar score, and delivery intervention due to fetal distress were evaluated. Results: Mean UCI in cases was 0.25±0.09 coil/cm. 534 cases(76.4%) were normocoiled, 87 cases(12.4%) and 78 cases(11.1%) were hypercoiled and hypocoiled respectively. There was no statistically significant correlation between UCI and maternal age and parity. There was statistically significant correlation between UCI and neonatal weight of more than 4000gr, and less than 2500gr(mean 19.02±12.41 versus 31.32±12.76) respectively(P=0.000), Apgar score less and more than 7 in 5th minute(mean 28.04±13.58 versus 25.06±8.7 respectively)(P=0.038), AFT≤5 and AFT>5(mean 29.1±11.44 versus 24.91±8.82 respectively)(P=0.001), meconium in amniotic fluid or no meconium(mean 28.9±9.94 versus 24.57±8.8)(P=0.000), maternal diabetes or no diabetes(mean 11±13.48 versus 25±8.6 respectively)(P=0.000), maternal hypertension and no hypertension(mean 22.96±12.62 versus 25.45±8.7 respectively)(P=0.047) and finally fetal distress or no fetal distress(mean 32.14±10.43 versus 24.43±8.6 respectively)(P=0.000). Conclusion: Abnormal UCI correlated with adverse perinatal outcome which can probably be used as a sonologic marker for finding the fetus at risk.