Umbilical cord coiling: definition, classification, clinical significance

Shchegolev A.I., Tumanova U.N., Lyapin V.M.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia
The normal development of the umbilical cord, which involves a coiled spiral appearance and the course of its vessels, underlies optimal fetal-placental blood flow. The article presents an analysis of the data available in the literature on the causes of umbilical cord coiling and the clinical significance of its degree. To quantify the vessel tortuosity of the umbilical cord, the investigators used a method to determine its coiling index, by dividing the number of complete coils of umbilical cord vessels by the total length of the umbilical cord in centimeters during ultrasound examination of a pregnant woman and/or macroscopic examination of the placenta immediately following birth. There is 1 coil per 5 cm or 0.2 coil per 1 cm in the normal umbilical cord. The umbilical cords with a coiling index of less than 0.07 coil/cm are regarded as hypocoiled; and those with a coiling index of more than 0.30 coil/cm are deemed as hypercoiled. The abnormal umbilical cord coiling indicators (hypocoiled or hypercoiled) are associated with different pregnancy and fetal developmental disorders: meconium-stained amniotic fluid, oligohydramnios, fetal growth restriction, fetal distress, placental abruption, premature birth, low Apgar scores, low ponderal index, and higher perinatal mortality rates.


umbilical cord
umbilical cord coiling index
perinatal complications


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Received 17.10.2018

Accepted 07.12.2018

About the Authors

Shchegolev, Aleksandr I., MD, professor, head of Morbid Anatomy, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel: +74955314444. E-mail:
Tumanova, Ulyana N., PhD, scientific researcher of Department of Morbid Anatomy, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel: +74955314444. E-mail:
Lyapin, Vyacheslav M., pathologist of Department of Morbid Anatomy, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4 Tel: +74955314444. E-mail:

For reference: Shchegolev A.I., Tumanova U.N., Lyapin V.M. Umbilical cord coiling: definition, classification, clinical significance. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (2): 42-50. (in Russian)

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