Assessment of Placental and Umbilical Cord Morphology with Analysis of Umbilical Coiling Index: A Cross-Sectional Study

Background: Every year 30 million infants suffer from Intrauterine Growth Retardation (IUGR). The mean IUGR rate in India is 54%. The prevalence of low birth weight in India is 26%. Placenta is the vital foeto-maternal unit responsible for the maintenance of pregnancy, foetal growth and development. Furthermore, the umbilical cord serves a paramount role in foetal intrauterine persistence. Assessment of umbilical cord and placental dimensions thus determine the foetal outcome. In addition, the umbilical coiling index has an impact on perinatal outcomes. Material and Methods: A cross-sectional investigation was conducted on 37 specimens of placenta with umbilical cords obtained from Department of Obstetrics and Gynecology, Akash Institute of Medical Sciences and Research Centre, Bengaluru. Placental form, diameter, placental cotyledons and mechanism of attachment of umbilical cord were observed. The length and diameter of umbilical cord, umbilical coiling index (UCI) were measured and statistical analysis was performed. Results: Mean diameter of placenta, diameter and length of umbilical cord, average number of placental cotyledons were  analyzed using SPSS 20. Percentage was calculated for shape of the placenta and mode of attachment of the umbilical cord to the placenta. UCI was calculated using the formula and  UCI of <10th percentile was classified as hypo coiled and UCI of  >90th percentile as hyper coiled. Conclusion: An extensive understanding of the placenta and umbilical cord, along with their clinical significance, is valuable for the early assessment of fetal well-being.

Keywords: Umbilical cord, placenta, umbilical coiling index, Intrauterine Growth Retardation, cotyledons.