Umbilical cord hypocoiling and late intrauterine fetal death: A case report and review of literature

Abstract

Abnormal coiling of the fetal umbilical cord is reported to be associated with poor fetal outcomes. The level of coiling may be accurately assessed sonographically from the second trimester, though its use has yet to become part of routine practice. It is hypothesized that natural coiling plays a role in protecting the umbilical vessels from external forces, with fewer coils offering less protection. Umbilical cord hypocoiling is defined as a coiling index (number of coils per centimeter length) below the 10th percentile and is associated with adverse perinatal outcomes including intrauterine growth restriction, increased rates of operative births and low Apgar scores at delivery. We present the case of a 24 year old primigravida woman with a pregnancy complicated by a term intrauterine fetal demise in early labor secondary to a fetal umbilical cord with no coils. Unfortunately, this was confirmed 5 h following a reassuring fetal CTG. A review of the literature highlights other similar cases and investigates best practice in regards to identification and management of these patients.L619418705 <br />