Umbilical Coiling Index and Perinatal Outcome


Priyanka Gaikwad
Kiran Patole


Objective(s): To study the association of umbilical coiling index and perinatal outcome. Method(s): One hundred and eighty five umbilical cords were examined. A coil is defined as a complete 360 degree spiral course of umbilical vessels around the Wharton's jelly. UCI was calculated by dividing the total number of coils by the umbilical cord length in centimeters. The outcomes measured were in terms of IUGR, fetal heart rate abnormalities during labor, meconium stained amniotic fluid, number of assisted deliveries was required, NICU admission, FSB, birth weight, ponderal index, various maternal medical illnesses. Hypocoiling was considered with UCI less than the 10th percentile and hypercoiling was considered UCI greater than the 90th percentile. Statistical analysis was done by Chi-square test, Fischer's exact test and the t-test where ever applicable. Results: The mean UCI in our study was found to be 0.19 + 0.08. 82.7% of the cords were normocoiled whereas 8.6% cords were hypocoiled as well as hypercoiled each. UCI below 0.09 was hypocoiling and above 0.26 was hypercoiling. In this study we found that PIH, IUGR, intrapartum FHR abnormalities, MSAF, increased instrumental deliveries, low APGAR scores, NICU admission, low birth weight and ponderal index were significantly associated with hypocoiling (P<0.05). IUGR and NICU admission were significantly associated with hypercoiling too (P<0.05). Conclusion: Our study thus shows that abnormal umbilical coiling index is associated with adverse perinatal outcome.


How to Cite
Gaikwad, P., & Patole, K. (2016). Umbilical Coiling Index and Perinatal Outcome. MVP Journal of Medical Sciences. Retrieved from


  1. Edmonds HW. The spiral twist of the normal umbilical cord in twins and in singletons. American Journal of Obstetrics and Gynecology. 1954; 67(1):102–20.
  2. Strong TH, Jarles DL, Vega JS, Feldman DB. The umbilical coiling index. Am J Obstet Gynecol. 1994; 170:29–32.
  3. Rana J, Ebert GA, Kappy KA. Adverse perinatal outcome in patients with an abnormal umbilical coiling index. Obstet Gynecol. 1995; 85:573–7.
  4. Lacro RV, Jones KL, Benirschke K. The umbilical cord twist: Origin, direction, and relevance. American Journal of Obstetrics and Gynecology. 1987; 157(4):833–8.
  5. Nakai Y, Imanaka M, Nishio J, Ogita S. Umbilical venous pulsation and regional circulatory disturbance. Ultrasound in Med and Biol. 1997; 23(8):1165–9.
  6. Gupta S, Faridi MMA, Krishna J. Umbilical coiling index. J Obstet Gynecol India. 2006 Jul/Aug; 56(4):315–9.
  7. Chitra T, Sushanth YS, Raghavan S. Umbilical coiling index as a marker of perinatal outcome: An analytical study. Obstetrics and Gynecology International. 2012; 2012:6. Article ID: 213689.
  8. Tripathy S. Umbilical coiling index and its relationship with perinatal outcomes.
  9. Agarwal S, Purohit R, Jain G. Umbilical cord coiling index and perinatal outcome in normal and abnormal pregnancies. Scholars Journal of Applied Medical Sciences. 2015; 2(1D):447–50
  10. De Laat MWM. Franx A, Bots ML, Visser GHA, Nikkels PGJ. Umbilical coiling index in normal and complicated pregnancies. Obstetrics and Gynecology. 2006; 107(5):1049–55.
  11. Reynolds SRM. Mechanisms of placentofetal blood flow. Obstet Gynecol. 1978; 51:245–9.
  12. Devaru D, Thusoo M. Umbilical coiling index and the perinatal outcome. Obstet Gynaecol India. 2012; 62(1):43–6.
  13. Machin GA, Ackerman J, Gilbert-Barness E. Abnormal umbilical cord coiling is associated with adverse perinatal outcome. Pediatr Devl Pathol. 2000; 3:462–71.
  14. Predanic M, Perni SC, Chasen ST, Baergen R, Chervenak FA. An assessment of the umbilical cord coiling during the routine fetalsonographic anatomic survey in the second trimester. J Ultrasound Med. 2005; 24:185–91.