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

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.

Update on Color Flow Imaging in Obstetrics

“…CDI or PDI over the internal os may help exclude vasa previa, a critical finding [39]. CFI is useful in detecting a nuchal cord and assessing its characteristics, including the number of circles of coiling, entanglement direction, and types (Figure 17A,B) [60]. Differentiating a true knot from a false knot of the umbilical cord is not easy.…”