ADVERSE PERINATAL OUTCOME IN PATIENTS WITH AN ABNORMAL UMBILICAL COILING INDEX

Objective: To evaluate perinatal outcome in neonates with hypocoiled and hypercoiled cords. Methods: From February 18 through Tune 13, 1994, 635 placentas from deliveries of at least 24 weeks' gestation were examined for umbilical coiling. The umbilical coiling index was calculated by dividing the total number of coils by the length of the cord. Subjects with umbilical coiling indices below the tenth percentile, above the 90th percentile, and between the tenth and 90th percentiles were defined as hypocoiled, hypercoiled, and normocoiled, respectively. Subjects with hypocoiled and hypercoiled cords were compared with those found to have normocoiled cords. Twelve different characteristics were used to measure perinatal outcome. Results: The subjects with hypocoiled cords differed from those with normocoiled cords in two significant ways: rates of fetal heart rate (FHR) disturbances and interventional delivery were higher in the hypocoiled group (28.6 versus 15.9% [P =.01] and 19 versus 7.1% [P =.002], respectively). The subjects with hypercoiled cords compared with those found to have normocoiled cords had a higher rate of premature delivery (33.3 versus 12.0% [P <.0001] and a higher incidence of cocaine use (12.7 versus 3.3% [P =.0006]). Conclusion: Hypocoiled cords can be predictors of potential interventional delivery and intrapartum FHR disturbances. Hypercoiled cords are associated with an increased incidence of premature delivery and maternal cocaine use.