Standardization of diagnosis for coiling of the umbilical cord around fetal neck by ultrasound

Int J Gynaecol Obstet. 2019 Oct;147(1):96-101. doi: 10.1002/ijgo.12909. Epub 2019 Jul 31.

Abstract

Objective: To elucidate classification of coiling of the umbilical cord around fetal neck (CUFN) by ultrasound and forming factors of entanglement angle of CUFN.

Methods: From January 2006 to December 2012, color Doppler ultrasonic was used to observe the blood flow vector of umbilical artery, and prospective descriptive observation was made for entanglement direction and type of 707 single fetuses taking prenatal examination in our hospital during the middle and late trimester of pregnancy and having umbilical cord echo around the neck. The relationship of position of fetus, position of placenta and entanglement direction of umbilical cord with the entanglement angle of umbilical cord is analyzed.

Results: Among the 707 fetuses, 634 had one circle of coiling, 43 had two circles of coiling, two had three circles of coiling, and 28 had CUFN. According to entanglement direction, 361 had entanglement from left to right and 318 had entanglement from right to left According to entanglement type, 305 were C-shaped type (43.14%), 85 were O-shaped type (12.02%), 289 were α-shaped type (40.88%), and 28 were L-shaped type (3.96%).

Conclusion: Color Doppler ultrasound was used to detect the entanglement direction of umbilical cord and establish the five-type classification of umbilical cord around the neck, laying the foundation for the feasibility of establishing the normalization of diagnostic standard of umbilical cord around the neck.

Keywords: Color Doppler flow imaging; Cord around neck; Diagnostic criteria; Twining direction; Ultrasonic typing.

MeSH terms

  • Adult
  • Female
  • Fetus / blood supply
  • Humans
  • Nuchal Cord / classification
  • Nuchal Cord / diagnosis*
  • Nuchal Cord / pathology
  • Pregnancy
  • Prospective Studies
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Prenatal
  • Umbilical Cord / blood supply
  • Umbilical Cord / diagnostic imaging*

Grants and funding