Prospective Observational Study Investigating the Association of Fetal Distress and Oligohydramnios With Antenatal Ultrasonographic Umbilical Cord Hypercoiling.

BACKGROUND

While abnormal umbilical cord coiling has been linked to various adverse perinatal outcomes, the antenatal associations remain poorly characterized and inconsistently reported across studies.

OBJECTIVE

We sought to evaluate whether ultrasonography-derived umbilical cord coiling parameters, particularly hypercoiling, are associated with fetal distress and oligohydramnios in singleton pregnancies.

METHODS

We conducted an observational analysis of 123 singleton pregnancies with complete follow-up data. Hypercoiling was defined using a prespecified coil-density cutoff of >0.3 coils/cm. We performed univariate logistic regression for each outcome; variables were based on clinical relevance, followed by prespecified multivariable models that included maternal age, gravida, coil count, and hypercoiling status.

RESULTS

Oligohydramnios occurred in 24 (19.5%) pregnancies, and hypercoiling was present in 32 (26.0%) cases. For fetal distress, coil count remained independently associated with lower odds in the multivariable model (adjusted OR: 0.524, 95% CI: 0.287-0.881; p=0.023), though hypercoiling itself showed no association. For oligohydramnios, hypercoiling remained independently associated with higher odds (adjusted OR: 3.18, 95% CI: 1.12-9.08; p=0.0286).

CONCLUSIONS

We found that hypercoiling was independently associated with oligohydramnios, while higher coil count was independently associated with lower odds of fetal distress. These findings suggest that different methods of assessing cord coiling may capture distinct pathophysiologic mechanisms.