Second trimester umbilical cord coiling index and perinatal outcomes

AMAÇ: Umblikal kord, fetüs ile plasenta arasındaki ilişkiyi sağ- layan, hem yapısal hem de fonksiyonel olarak basit görülen, ancak gelişmekte olan fetüsün yaşamında kritik bir rol üstle- nen yaşam bağıdır. Çalışmamızın amacı perinatal sonuçları öngörmede erken dönemde bakılan umblikal kord sarmal sayı indeksinin önemini araştırmaktır. GEREÇ VE YÖNTEM: Çalışmaya gebe polikliniğine başvuran 18-24. gestasyonel haftalarda tek, canlı gebeliği olan 271 ge- be dahil edildi ve prospektif olarak izlendi. Hastaların yaş, obstetrik hikayesi, bu gebeliğinde sigara kulla- nıp kullanmadığı ve gebelik öncesi beden kitle indeksi (BKI) değerleri kaydedildi. Antenatal umblikal sarmal sayı indeksi (aUCI) hesaplaması yapıldı. Bu gebeler izlenerek preeklamp- si, GDM, intrauterin gelişme kısıtlılığı (IUGR), gestasyonel ya- şa göre küçük fetus (SGA) gelişip gelişmediği ayrıca doğum ki- losu, doğum şekli, doğum yaptığı hafta, yenidoğan yoğun ba- kım ihtiyacı olup olmadığı, 5. dakika apgar skoru kaydedildi. BULGULAR: Antenatal kordon sarma endeksi (aUCİ) ve ge- belik yaşı arasında negatif korelasyon. Hiposarmal umblikal kordon yapısı olan hastalarda doğum kilosu anlamlı olarak da- ha azdı. Sarmal sayı indeksi normal olanların preeklampsi ora- nı %3,93 iken, hiposarmal olanlarda %26,09, hipersarmal olan- larda %21,05 olduğu bulundu. Sarmal sayı indeksi normal olanların GDM oranı %2,18 iken, hiposarmal olanlarda %13,04, hipersarmal olanlarda %10,53 olduğu bulundu. Sarmal sayı indeksi normal olanların IUGR oranı %3,49 iken, hiposarmal olanlarda %21.74, hipersarmal olanlarda %5,26 ol- duğu bulunmuştur. Sarmal sayı indeksine göre; GDM, preek- lampsi ve IUGR yönünden istatistiksel olarak anlamlı bir fark olduğu bulundu (p

İkinci trimester umblikal kord sarmal indeksi ve perinatal sonuçları

OBJECTIVE: Umbilical cord usually seems simple functionally and structurally but it's the life link be- tween fetus and mother that was critically important for growing fetus. The aim of this study is to evalu- ate the effect of early umbilical cord coiling index on perinatal outcomes. STUDY DESIGN: 221 patients with singleton, alive pregnancies between 18-24 gestational weeks were included in our study and have been evaluated prospectively. Patients’ age, obstetric history, BMI before pregnancy, history of smoking was registered. Umbilical arter coiling index was also calculated. Perinatal problems such as preeclampsia, gestational diabetes mel- litus (GDM), intrauterine growth restriction (IUGR), small for gestational age (SGA) and birth weight, ges- tational age at birth, and newborn intensive care unit need were recorded. RESULTS: There was a negative correlation between antenatal umbilical cord coiling index (aUCI) and gestational age. The birth weights were lower in patients with hypocoiled umbilical cord structure. Preeclampsia was seen in 3.93% of patients with normal aUCI, 26.09 % in hypocoiling group, and 21.05 % in hypercoiling group. The percentage of patients with normal aUCI who had GDM is 2.18, 13.04% of patients with hypercoiling and 10.53% of patients with hypocoiling had GDM. The percentage of patients with normal aUCI who had IUGR is 3.49, 21.74% of patients with hypercoiling and 5.26% of patients with hypocoiling had IUGR. According to aUCI there was a statistical difference in GDM, preeclampsia and IUGR and different from the literature, in our study, we found a statistically significant difference in hy- percoiled umbilical cords in terms of preeclampsia. Newborns with hypercoiling or hypocoiling were needed more neonatal intensive care unit. CONCLUSIONS: There was measured correlation between umbilical cord diameter and aUCI between 18-24 weeks and perinatal outcome but new prospective studies about umbilical artery morphology and perinatal outcomes are also needed.

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