Non-coiled umbilical blood vessels: a new marker for the fetus at risk.

Abstract

To evaluate the perinatal outcomes of fetuses born with non-coiled umbilical blood vessels. We performed a prospective study of umbilical cords that lacked umbilical vascular coiling. The perinatal outcomes were compared with those of neonates born with coiled umbilical blood vessels. Thirty-eight (4.3%) of 894 fetuses were born with non-coiled umbilical vessels. The non-coiled group had a significantly increased incidence of intrauterine death (P = .009), preterm delivery (P = .006), repetitive intrapartum fetal heart rate decelerations (P < .00005), operative delivery for fetal distress (P < .00005), meconium staining (P = .007), and anatomical-karyotypic abnormalities (P = .03). Our findings suggest that the fetus with non-coiled (ie, straight) umbilical blood vessels is at increased risk for perinatal morbidity and mortality. Non-coiled umbilical vessels may represent a pathologic developmental process that places the fetus at risk. Moreover, absence of the normal coiled umbilical configuration may result in a cord that is structurally less able to resist external compressive forces.