Effect of Antenatal Umbilical Coiling Index on Doppler Parameters of Umbilical Cord Vessels

Aqib Umair, Anjum Tazeen, Muhammad Uzair, Fizza Rauf, Syed Muhammad Yousaf Farooq


Purpose: To assess the effect of antenatal umbilical coiling index on Doppler parameters of umbilical cord vessels.

Material and Methods: This cross-sectional analytical study was conducted in a large health services hospital and total of 48 pregnant women were included in study. These women were between 28 and 42 weeks of gestation. Transabdominal sonography was used to study antenatal umbilical coiling index and its relationship with Doppler parameters of umbilical vessels blood flow was assessed.

Results: The mean gestational age of cases was 31.47 ± 2.45. The antenatal umbilical coiling index was found to be 0.42 ± 0.1 with values 0.27 and 0.57 being the 10th and 90th percentile. In terms of the coiling pattern, 8% exhibited hypercoiling, 10% showed hypocoiling, and the remaining 82% were classified as normocoiled. There was a non-significant correlation of UCI with PSV (r=0.202, P=0.169) and RI (r=0.018, P=0.905) of umbilical arteries. The correlation of UCI with umbilical vein velocity (r=0.432, P=0.002) and blood flow rate (r=0.668, P=0.00) was strong and significant.

Conclusion: Antenatal umbilical coiling index can be assessed on ultrasonography and there was a significant relationship between Doppler flow parameters of umbilical vein and the umbilical coiling index. It showed that umbilical coiling does promote venous blood flow in umbilical vein. Moreover, there was a non-significant relationship between umbilical coiling index and Doppler flow parameters of umbilical arteries.


Umbilical Cord, Ultrasonography, Doppler, Blood Circulation

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Hegazy AA. Anatomy and embryology of umbilicus in newborns: a review and clinical correlations. Frontiers of Medicine. 2016 Sep; (3):271–7.

Leveno KJ, Spong CY, Casey BM, et al. Williams Obstetrics. 25th ed. McGraw-Hill Education / Medical; 2018.

van Dijk CC, Franx A, de Laat MWM, et al. The umbilical coiling index in normal pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine. 2002 Jan; (4):280–3.

Khong TY. Evidence-based pathology: umbilical cord coiling. Pathology. 2010 Dec; (7):618–22.

Narayan R, Hyett J. P05.04: Ultrasound assessment of umbilical cord morphology in the first trimester: a feasibility study. Ultrasound in Obstetrics & Gynecology. 2013 Oct; (s1):129–129

Ayala NK, Ernst LM, Miller ES. Is umbilical coiling genetically determined? Journal of Perinatology. 2018 Feb 21; (6):653–7.

Verkleij CPM, van Oppen ACC, Mulder EJH, et al. Evaluation of antenatal umbilical coiling index at 16-21 weeks of gestation as a predictor of trisomy 21 and other chromosomal defects. Ultrasound in Obstetrics & Gynecology. 2013 Oct 27; (5):545–52.

Coetzee AJ, Castro E, Peres LC. Umbilical Cord Coiling and Zygosity: Is there a Link? Fetal and Pediatric Pathology. 2015 Aug 20; (5):336–9.

Machin GA, Ackerman J, Gilbert-Barness E. Abnormal umbilical cord coiling is associated with adverse perinatal outcomes. Pediatr Dev Pathol 2000; 3(5): 462e71.

Ohno Y, Terauchi M, Tamakoshi K. Perinatal outcomes of abnormal umbilical coiling according to a modified umbilical coiling index. Journal of Obstetrics and Gynaecology Research. 2016 Aug 16;


Alfirevic Z, Stampalija T, Dowswell T. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database of Systematic Reviews. 2017 Jun 13; (6).

Chitra T, Sushanth YS, Raghavan S. Umbilical Coiling Index as a Marker of Perinatal Outcome: An Analytical Study. Obstetrics and Gynecology International. 2012; 1–6.

Sharma R, Radhakrishnan G, Manchanda S, et al. Umbilical Coiling Index Assessment during Routine Fetal Anatomic Survey: A Screening Tool for Fetuses at Risk. The Journal of Obstetrics and Gynecology of India. 2017 Sep 14; (5):369–75.

de Laat M, Franx A, van Alderen E, et al. The umbilical coiling index, a review of the literature. The Journal of Maternal-Fetal & Neonatal Medicine. 2005 Feb 1; (2):93–100.

Degani S, Mlewinsky R, Berger H, et al. Sonographic estimation of umbilical coiling index and correlation with Doppler flow characteristics. Obstetrics & Gynecology. 1995 Dec; (6):990–3.

Khong, T. Y. “Evidence-Based Pathology: Umbilical Cord Coiling.” Pathology, no. 7, Elsevier BV, Dec. 2010, pp. 618–22.

Strong TH, Jarles DL, Vega JS, et al. The umbilical coiling index. Am J Obstet Gynecol 1994;170:29–32.

Ezimokhai M, Rizk DEE, Thomas L. Abnormal Vascular Coiling of the Umbilical Cord in Gestational Diabetes Mellitus. Archives of Physiology and Biochemistry. 2001 Jan; (3):209–14.

Kashanian M, Akbarian A, Kouhpayehzadeh J. The umbilical coiling index and adverse perinatal outcome. International Journal of Gynecology & Obstetrics 2006; 95: 8–13.

Predanic M, Perni SC, Chervenak FA. Antenatal umbilical coiling index and Doppler flow characteristics. Ultrasound in Obstetrics and Gynecology. 2006; (5):699–703.

Reynolds SR. The umbilical cord. Sci Am 1952; 187: 70–74.

Reynolds SR. Mechanisms of placentofetal blood flow. Obstet Gynecol 1978; 51: 1165–1169.

Nakai Y, Imanaka M, Nishio J, et al. Umbilical venous pulsation and regional circulatory disturbance. Ultrasound in Med and Biol 1997;23(8):1165–1169.

DOI: http://dx.doi.org/10.36162/hjr.v8i3.557


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