Study On The Correlation Between Umbilical Coiling Density And Perinatal Outcome In Ultrasonic Multi-Quadrant Screening

Objective:In order to evaluate the perinatal outcome and improve the limitation of umbilical cord ultrasonography,we tried to use the multi-quadrant method to track the full length of umbilical cord and calculate the prenatal umbilical coiling index(aUCI)at 20-32 weeks of pregnancy.Methods:A total of 242 pregnant women at 20 to 32 weeks gestation who underwent ultrasound examination and gave birth in the obstetrics department of Baoding First Central Hospital from March 2021 to March 2022 were selected as research objects.The umbilical coiding index(UCI)of these pregnant women was measured,and the data of all enrolled pregnant women were recorded.Age,body mass index(BMI),gestational age,gestational age at delivery(preterm birth),fetal weight(low birth weight),1min Apgar score ≤7 and the number of cases with FGR were recorded.The prenatal umbilical cording index and postpartum umbilical coiling index(pUCI)were calculated by the total number of umbilical cord coils /total umbilical cord length(cm).The correlation between aUCI and pUCI was calculated,and the reliability of aUCI in predicting pUCI was evaluated.The correlation between aUCI and pUCI was evaluated in 20-32 three stages(20-24 weeks,25-28 weeks,29-32 weeks).According to the 10 th and 90 th percentile of aUCI,the subjects were divided into three groups:group A with dense umbilical coiling(aUCI > 90 th percentile),group B with normal umbilical coiling(aUCI between 10 th and 90th percentile)and group C with umbilical coiling osteoporosis(aUCI <10th percentile).This paper mainly studies the umbilical coiling density,so the umbilical coiling osteoporosis group is no longer studied and discussed.The cases of preterm delivery,low birth weight infants,1min Apgar score≤7 and FGR in umbilical cord dense group and normal group were calculated.The above parameters were analyzed and evaluated by SPSS26.0 to analyze whether aUCI can predict pUCI and the correlation between umbilical coiling density and adverse perinatal outcome.Results:We have complete data on 242 subjects.The average aUCI was 0.34±0.10 coils/cm and the average pUCI was 0.28±0.10 coils/cm.1.The correlation coefficient between aUCI and pUCI measured by prenatal multi-quadrant method was 0.772(P < 0.001).2.The correlation coefficient between aUCI and pUCI measured at the20 th and 24 th week of pregnancy was 0.749(P < 0.001),that between aUCI and pUCI at 25 th and 28 th week was 0.771(P < 0.001),and that between aUCI and pUCI at 29 th and 32 th week was 0.805(P < 0.001).3.There were 22 cases in group A with dense umbilical coiling(aUCI >0.47),201 cases in group B with normal umbilical coiling(0.21≤aUCI≤0.47).In the group with dense umbilical cord helix,the incidences of preterm delivery,low birth weight infants,1 min Apgar score≤7 and FGR were 31.8%,36.4%,27.3% and 27.3%,respectively.In the normal umbilical cord helix group,the incidences of preterm delivery,low birth weight infants,1min Apgar score 7 and FGR were 10.0%,6.9%,5.5% and 5.0%,respectively.There were significant differences in the incidence of preterm delivery,low birth weight infants,1 min Apgar score≤7 and FGR between the dense umbilical cord group and the normal group(P < 0.05).Conclusions:The prenatal umbilical coiling index can be easily obtained by multi-quadrant method at 20-32 weeks of gestation,and this method is reliable to predict postpartum umbilical coiling index.The incidence of adverse perinatal outcome such as preterm delivery,low birth weight infants,1min Apgar score≤7 and FGR was higher when the umbilical cord was dense.