Umbilical Cord Coiling Index as A Predictor of Adverse Perinatal Outcome in Term Pregnancies

It is hypothesized that the abnormal coiling of the umbilical cord, which is measured by the Umbilical Cord Coiling Index (UCCI), interferes with the fetal hemodynamics of the placenta. Although it is linked with the poor outcome in high-risk pregnancies, its prognostic value in terms, ostensibly low-risk pregnancies needs additional confirmation to inform the antenatal surveillance and intrapartum care. This paper identified the purpose of this study, which was to assess the UCCI as a predictor of poor perinatal outcomes in a group of term pregnancies. The cross-sectional study involved 104 women with singleton term pregnancies (37 weeks and above), in which all the data will be collected in different hospitals in Iraq within 12 months of follow-up between January 2024 and January 2025, as well as the UCCI, which was noted after delivery (coils/cm), where the cohorts were divided into hypo coiling (UCCI < 0.10, 10.6%), norm coiling (UCCI 0.10-0.30, 78.8%), and hyper coiling (UCCI > 0.30, 10.6%). We ended up with a composite of the adverse perinatal events (operative births due to fetal distress, 5-minute Apgar below 7, umbilical artery pH below 7.10, or NICU stay longer than 24 h). Comparisons were made on maternal, delivery, and neonatal factors. Hypo coiling and hyper coiling were significantly more linked to composite adverse outcomes (45.5% and 54.5%, respectively) than norm coiling (11.0%). Abnormally coiled groups of neonates were found to have very low 5-minute Apgar scores and umbilical artery pH. Hypo coiling (aOR 5.81, 95% CI 1.42–23.8) and hyper coiling (aOR 8.25, 95% CI 2.01–33.9) were also significant independent predictors after the variables of maternal age, nulliparity, and gestational diabetes were adjusted. A UCCI that was not within the normal range was found to predict the composite outcome with a sensitivity of 68.8, a specificity of 85.7, and a negative predictive value of 92.7. Both hypo coiling and hyper coiling are correlated factors in the negative perinatal outcomes in term pregnancies. The presence of a norm coiled cord is an indicator of a strong, reassuring appearance (high NPV). Routine postnatal screening of UCCI is an excellent risk-stratification instrument because it can define a cohort of term neonates at risk of greater benefit from increased antenatal and intrapartum surveillance despite a low-risk pregnancy.