RETRACTED: Factors related to morbidity and maternal and perinatal outcomes of umbilical cord torsion

Abstract

This study analyzed factors influencing umbilical cord torsion, measured the umbilical coiling index (UCI) postnatally, and analyzed the association of umbilical cord torsion with maternal and perinatal outcomes. Methods: In total, 845 antenatal women who went into labor at the Fujian Provincial Maternity and Children's Hospital from January 2016 to January 2017 were retrospectively studied. The patients were divided into those with and without umbilical cord torsion. Possible influencing factors and the UCI were noted, and maternal and perinatal outcomes were compared. Results: Higher morbidity in the presence of umbilical cord torsion was affected by multiparous pregnancy and a long cord. The area under the curve was 0.666 for the UCI to predict fetal distress and 0.505 for the umbilical artery peak systolic to end diastolic flow velocity ratio (S/D ratio) to predict fetal distress. Umbilical cord torsion was associated with higher rates of fetal distress, forceps-assisted delivery, cesarean sections, fetal heart rate abnormalities, amniotic fluid meconium staining, neonatal intensive care unit admission, and small for gestational age. Conclusions: Multiparous status and longer umbilical cord length were highly associated with umbilical cord torsion. The UCI is a better predictor of fetal distress than is the umbilical artery S/D ratio.

Correlation between umbilical cord torsion and Doppler parameters of umbilical artery: a single-center retrospective case-control study

“…This study included 1608 pregnant women who delivered in our hospital (666 in the case group and 942 in the control group).According to the inclusion exclusion criteria, 646 pregnant women (251 in the case group and 395 in the control group) were excluded, and 415 pregnant women in the case group and 547 pregnant women in the control group were finally included.Pregnant women ranged in age from 21 to 44 years, with a mean age of 31 years (P > 0.05). A total of 4215 umbilical artery Doppler flow parameters were collected in the case group (1676 in the case group and 2543 in the control group), of which basically each included the peak rate of umbilical artery contraction (PSV) and the umbilical artery flow resistance parameters (S/D), and some of them lacked the resistance parameters RI (19) and PI (75) in the umbilical artery group. The average values of umbilical artery Doppler parameters in the case group and the control group at different gestational ages were shown in Table 1, indicating that the average values of PSV, S/D, RI and PI of umbilical artery in the case group were lower than those in the control group at different gestational ages.…”

“…Therefore, when the fetus has abnormal fetal heart monitoring and abnormal fetal movement, and the Doppler parameters of umbilical artery blood flow do not increase abnormally or decrease instead, the possibility of umbilical cord torsion should be considered. It has been reported that the high helix of umbilical cord is related to umbilical cord torsion [19-21] . It has been reported that when the umbilical cord is high helical, the umbilical vein blood flow velocity at the umbilical wheel will increase [22,23] or the a-wave reverse of the venous catheter will occur [24] .…”

“…1). The Doppler parameters of umbilical artery blood flow are the routine indexes of prenatal ultrasound examination.At present, most of the bad pregnancies are related to the abnormal increase of umbilical artery blood Doppler resistance parameters [14][15][16][17][18] .When obstetricians suspect fetal distress or abnormal fetal movement, they usually pay more attention to the abnormal increase in Doppler resistance of umbilical artery blood flow.If there is no abnormal increase in Doppler resistance of umbilical artery blood flow, we often relax our vigilance and think that the fetus is safe for the time being, and it is recommended that the fetus be reexamined in the near future.During the time waiting for reexamination, the fetus may die in the uterus due to torsion of the umbilical cord, missing the best rescue opportunity.Therefore, when the fetus has abnormal fetal heart monitoring and abnormal fetal movement, and the Doppler parameters of umbilical artery blood flow do not increase abnormally or decrease instead, the possibility of umbilical cord torsion should be considered.It has been reported that the high helix of umbilical cord is related to umbilical cord torsion [19][20][21] . It has been reported that when the umbilical cord is high helical, the umbilical vein blood flow velocity at the umbilical wheel will increase [22,23] or the a-wave reverse of the venous catheter will occur [24] .Therefore, when suspected umbilical cord torsion, we also need to pay attention to the contents of unconventional ultrasound examination, such as umbilical cord helix, umbilical vein flow velocity and venous catheter spectrum and so on.…”

Reporte de caso: torsión de cordón umbilical como causa de muerte fetal

“…Esto genera una presión negativa relativa en la vena, lo que a su vez ayuda a aumentar el flujo sanguíneo desde la placenta hacia el feto. Se ha establecido que los giros fisiológicos comprenden alrededor de 12 espirales, lo que confiere al cordón umbilical flexibilidad y resistencia ante fuerzas externas 6,7 . Este estudio describe los hallazgos de una autopsia de un caso atipico de torsión de cordón umbilical asociado a polihidramnios severo, realizado en el Instituto Nacional de Patología Dr. Sergio Sarita Valdez en el mes de abril.…”