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Volume-13 Number-1, 2026 / Original Article
Clinical Utility of Umbilical Coiling Index in Perinatal Risk Stratification
Author:
Katyayani Singh
Postgraduate trainee, Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India.
Ayesha Ahmad
Department of Obstetrics and Gynaecology,Career Institute of Medical Sciences and Hospital, Lucknow, UP, India
Suman Nishad
Department of Obstetrics and Gynaecology,Career Institute of Medical Sciences and Hospital, Lucknow, UP, India
Himanshu Arora
Postgraduate trainee, Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India.
Sumaiyya Shamsi
Department of Paediatrics, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India
Postgraduate trainee, Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India.
Ayesha Ahmad
Department of Obstetrics and Gynaecology,Career Institute of Medical Sciences and Hospital, Lucknow, UP, India
Suman Nishad
Department of Obstetrics and Gynaecology,Career Institute of Medical Sciences and Hospital, Lucknow, UP, India
Himanshu Arora
Postgraduate trainee, Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India.
Sumaiyya Shamsi
Department of Paediatrics, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India
Abstract:
Background: The umbilical cord plays an essential role in feto-maternal exchange. Its vascular coiling contributes to its structural strength and function. The umbilical Coiling Index (UCI) is a simple measure used to assess this coiling. Abnormal coiling, either reduced or excessive, has been linked to adverse perinatal outcomes, but data from Indian populations remain limited.
Objective: To study the association between the Umbilical Coiling Index (UCI) and perinatal outcomes in term pregnancies.
Methods: This cross-sectional observational study was carried out over 24 months in the Department of Obstetrics and Gynaecology, ELMCH, Lucknow. A total of 196 term singleton deliveries (37–41 weeks) were included. The umbilical cord was examined postnatally for length, number of complete vascular coils, and other morphological features. UCI was calculated as the number of complete coils per centimetre of cord length and was categorised, based on the distribution in the study population, as hypo-coiled (UCI<0.12), normo-coiled (UCI-0.12–0.36), and hyper-coiled (UCI>0.36). Maternal, foetal, and neonatal outcomes were analysed statistically using SPSS version 25.0, with p<0.05 considered significant.
Results: The mean UCI was 0.161 ± 0.034 spirals/cm. Of 196 cases, 63.3% were normo-coiled, 14.8% hypo-coiled, and 21.9% hyper-coiled. Abnormal coiling was associated with adverse outcomes, including low Apgar scores, increased NICU admissions, foetal growth restriction and abnormal foetal heart rate patterns. Caesarean section rates were higher among hypo-coiled cords due to non-reassuring foetal status. Maternal comorbidities—particularly hypertensive disorders and GDM—showed frequent overlap with abnormal UCI.
Conclusion: Both hypo- and hyper-coiled umbilical cords were linked with adverse perinatal outcomes. UCI measurement, especially when integrated with foetal growth and Doppler studies, can serve as a simple, non-invasive marker for antenatal risk stratification. Larger multicentric studies are warranted to establish its routine use in obstetric practice.
Keywords:
Foetal growth restriction, Hypo-coiling, Hyper-coiling, NICU admission, Perinatal outcome, Umbilical Coiling IndexLicense:
Copyright (c) 2026 Era's Journal of Medical Research
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View in DOI
10.24041/ejmr.2026.3