Three-dimensional Umbilical Cord Coiling Index
Study Details
Study Description
Brief Summary
Previous studies have shown that abnormal coiling of the umbilical cord is associated with adverse perinatal outcome. For example, an umbilical cord that is non-coiled increases the chance of fetal morbidity and mortality, moreover, they have shown that the lack of the usual coiled umbilical cord configuration may result in an umbilical cord that is structurally less able to withstand external mechanical stress, on the other hand, studies from recent years show that hypercoiling - excessive coiling of the umbilical cord is associated with poor obstetric outcomes, such as fetal distress at birth, meconium staining, fetal acidosis, premature birth, intrauterine growth disorder and even fetal death.
The studies carried out on the calculation of UCI include performing these measurements in two dimensions, including Doppler activation, but no studies were carried out in which three dimensions were used. The purpose of the study is to measure UCI using a 3D method in a random sample of 250 patients beyond 24 week of gestation, and to compare pregnancies with hypercoiling, hypocoiling or with a normal number of coils in terms of birth outcomes.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
The umbilical cord connects the growing fetus to the placenta and contains 3 blood vessels, 2 arteries and a vein. The umbilical cord is protected by a layer of Wharton jelly and is characterized by being coiled. This coiling provides the umbilical cord with strength and flexibility simultaneously, and as a result lowers the risk of complications such as torsion of the umbilical cord.
The reason for the formation of this coiling is unknown, but there are many hypotheses such as mobility and rotation of the fetus around the axis of the umbilical cord, a different growth pattern of the blood vessels in the umbilical cord and a special arrangement of the muscles in the walls of the arteries of the umbilical cord.
Umbilical cord index (UCI) is the distance between one coil of the umbilical cord. it is calculated from the inner edge of the wall of an umbilical cord artery or vein to the outer edge of the same vessel in the next coil, the direction is from the edge of the placenta to the fetus. The final value is the average of three readings in three different segments of the umbilical cord.
Previous studies have shown that abnormal coiling of the umbilical cord is associated with adverse perinatal outcome. For example, an umbilical cord that is non-coiled increases the chance of fetal morbidity and mortality, moreover, they have shown that the lack of the usual coiled umbilical cord configuration may result in an umbilical cord that is structurally less able to withstand external mechanical stress, on the other hand, studies from recent years show that hypercoiling - excessive coiling of the umbilical cord is associated with poor obstetric outcomes, such as fetal distress at birth, meconium staining, fetal acidosis, premature birth, intrauterine growth disorder and even fetal death.
The studies carried out on the calculation of UCI include performing these measurements in two dimensions, including Doppler activation, but no studies were carried out in which three dimensions were used. The purpose of the study is to measure UCI using a 3D method in a random sample of 250 patients beyond 24 week of gestation, and to compare pregnancies with hypercoiling, hypocoiling or with a normal number of coils in terms of birth outcomes.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| The study cohort (total sample) All women will undergo ultrasound examination for three-dimensional umbilical cord index. |
Diagnostic Test: Ultrasound
The intervention is ultrasound examination with three dimensional umbilical cord index, two-dimensional umbilical cord index, and doppler examination of the umbilical cord artery.
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Outcome Measures
Primary Outcome Measures
- Intrauterine growth restriction [1 year]
The correlation between three-dimensional umbilical cord index and the rate of intrauterine growth restriction
Secondary Outcome Measures
- Two-dimensional umbilical cord index [1 year]
The correlation between three-dimensional umbilical cord index and the two-dimensional umbilical cord index
- Doppler index of the umbilical cord [1 year]
The correlation between three-dimensional umbilical cord index and the doppler index of the umbilical cord
- fetal distress during delivery [2 years]
The correlation between three-dimensional umbilical cord index and the rate of fetal distress during delivery
- Meconium staining [2 years]
The correlation between three-dimensional umbilical cord index and meconium staining at delivery
- Delivery mode [2 years]
The correlation between three-dimensional umbilical cord index and the delivery mode
- Cord pH [2 years]
The correlation between three-dimensional umbilical cord index and Cord pH
- APGAR score [2 years]
The correlation between three-dimensional umbilical cord index and APGAR score
- Newborn intensive care unit admission [2 years]
The correlation between three-dimensional umbilical cord index and admission to NICU
Eligibility Criteria
Criteria
Inclusion Criteria:
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Singleton pregnancy
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Pregnancy week > or = 24.0
Exclusion Criteria:
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Twin pregnancy
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Pregnancy week<24
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Single umbilical cord
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Insufficient prenatal care
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Abnormal anatomical fetal findings, abnormal results of aneuploidy screening
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Premature rupture of membranes
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Polyhydramnios or Oligohydramnios at the time of recruitment.
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Intrauterine growth restriction at the time of recruitment
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Galilee Medical Center | Nahariya | Hazafon | Israel |
Sponsors and Collaborators
- Western Galilee Hospital-Nahariya
Investigators
- Principal Investigator: Marwan Odeh, MD, Galilee Medical Center
Study Documents (Full-Text)
None provided.More Information
Publications
- Chitra T, Sushanth YS, Raghavan S. Umbilical coiling index as a marker of perinatal outcome: an analytical study. Obstet Gynecol Int. 2012;2012:213689. doi: 10.1155/2012/213689. Epub 2012 Feb 14.
- de Laat MW, Franx A, van Alderen ED, Nikkels PG, Visser GH. The umbilical coiling index, a review of the literature. J Matern Fetal Neonatal Med. 2005 Feb;17(2):93-100. doi: 10.1080/14767050400028899.
- Degani S, Lewinsky RM, Berger H, Spiegel D. Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstet Gynecol. 1995 Dec;86(6):990-3. doi: 10.1016/0029-7844(95)00307-d.
- Ma'ayeh M, McClennen E, Chamchad D, Geary M, Brest N, Gerson A. Hypercoiling of the umbilical cord in uncomplicated singleton pregnancies. J Perinat Med. 2018 Aug 28;46(6):593-598. doi: 10.1515/jpm-2017-0034.
- Machin GA, Ackerman J, Gilbert-Barness E. Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Pediatr Dev Pathol. 2000 Sep-Oct;3(5):462-71. doi: 10.1007/s100240010103.
- Rana J, Ebert GA, Kappy KA. Adverse perinatal outcome in patients with an abnormal umbilical coiling index. Obstet Gynecol. 1995 Apr;85(4):573-7. doi: 10.1016/0029-7844(94)00435-G.
- Sharma B, Bhardwaj N, Gupta S, Gupta PK, Verma A, Malviya K. Association of umbilical coiling index by colour Doppler ultrasonography at 18-22 weeks of gestation and perinatal outcome. J Obstet Gynaecol India. 2012 Dec;62(6):650-4. doi: 10.1007/s13224-012-0230-0. Epub 2012 Aug 17.
- Strong TH Jr, Elliott JP, Radin TG. Non-coiled umbilical blood vessels: a new marker for the fetus at risk. Obstet Gynecol. 1993 Mar;81(3):409-11.
- 0080-22-NHR