Prediction of postnatal abnormal umbilical cord coiling by antenatal evaluation in pregnant women: Diagnostic accuracy study: a systematic review

Leila Ghalichi; Omolbanin Asadi  Ghadikolaei; Nazanin  Hosseinkhan; Azadeh  Abedini; Shahnaz  Ahmadi; Laily Najafi

doi:10.1111/jog.15781

Prediction of postnatal abnormal umbilical cord coiling by antenatal evaluation in pregnant women: Diagnostic accuracy study: a systematic review

Leila Ghalichi, Omolbanin Asadi Ghadikolaei, Nazanin Hosseinkhan, Azadeh Abedini, Shahnaz Ahmadi, Laily Najafi^*

^*Corresponding author for this work

Applied Health Research

Research output: Contribution to journal › Article › peer-review

Abstract

Study Objective: Umbilical cord abnormalities increase neonatal morbidity and mortality. Considering uncertainties about the best time of an antenatal ultrasonography scan to evaluate the umbilical coiling index (UCI), this systematic review was designed to assess the diagnostic accuracy value of antenatal ultrasound assessments to predict abnormal postpartum UCI.

Methods: All observational, cross-sectional, case–control, cohort, and diagnostic accuracy studies up to March 26, 2022, were searched and assessed according to PRISMA guidelines in Ovid, Cochrane, Scopus, PubMed, Web of Science, Embase, Proquest, Science Direct, and Clinical Key databases, and Google Scholar search engine.

Results: The total number of 63 190 documents were retrieved from databases. The duplicates (19 272) were removed, 43 918 articles were screened for relevance, and 56 papers were selected for full-text evaluation, resulting in 14 qualified pieces subjected to the quality CASP tools for each type of study. Finally, six articles were evaluated, extracted, and confirmed. Overall, we had 16 evaluations (11 normal pregnancies, 4 gestational diabetes mellitus, and 1 group at risk for small gestational age), from which 9 and 7 were respectively performed in the second and third trimesters. Most of the evaluations considered both hypocoiling and hypercoiling. The sensitivity, specificity, and area under curves (AUCs) change range between the evaluations were 0.09–0.97, 0.59–0.96, and 0.262–0.84, respectively.

Conclusion: Observing any coiling abnormalities in every trimester, both the second and third, is highly sensitive to predicting abnormal postnatal UCI (pUCI). Conclusively, any detected antenatal abnormality is worth attention. Both trimesters' evaluations are essential, and no superiority is seen for any of them. The systematic review revealed statistical and clinical heterogeneity; a meta-analysis was impossible.

Original language	English
Number of pages	8
Journal	Journal of Obstetrics and Gynaecology Research
Early online date	28 Aug 2023
DOIs	https://doi.org/10.1111/jog.15781
Publication status	E-pub ahead of print - 28 Aug 2023

Bibliographical note

Funding Information:
This study was funded and supported by the Iran University of Medical Sciences (IUMS); Grant No. 98‐1‐37‐14773. The authors wish to thank the staff of the Endocrine Research Center, who immensely helped us to complete the project.

Publisher Copyright:
© 2023 Japan Society of Obstetrics and Gynecology.

Keywords

antenatal
diagnostic accuracy study
postnatal
prediction
ultrasound assessment
umbilical coiling index

ASJC Scopus subject areas

Obstetrics and Gynaecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jog.15781Licence: None: All rights reserved

Cite this

@article{deee0367c4db49f79b6f33ba509ffff9,

title = "Prediction of postnatal abnormal umbilical cord coiling by antenatal evaluation in pregnant women: Diagnostic accuracy study: a systematic review",

abstract = "Study Objective: Umbilical cord abnormalities increase neonatal morbidity and mortality. Considering uncertainties about the best time of an antenatal ultrasonography scan to evaluate the umbilical coiling index (UCI), this systematic review was designed to assess the diagnostic accuracy value of antenatal ultrasound assessments to predict abnormal postpartum UCI. Methods: All observational, cross-sectional, case–control, cohort, and diagnostic accuracy studies up to March 26, 2022, were searched and assessed according to PRISMA guidelines in Ovid, Cochrane, Scopus, PubMed, Web of Science, Embase, Proquest, Science Direct, and Clinical Key databases, and Google Scholar search engine. Results: The total number of 63 190 documents were retrieved from databases. The duplicates (19 272) were removed, 43 918 articles were screened for relevance, and 56 papers were selected for full-text evaluation, resulting in 14 qualified pieces subjected to the quality CASP tools for each type of study. Finally, six articles were evaluated, extracted, and confirmed. Overall, we had 16 evaluations (11 normal pregnancies, 4 gestational diabetes mellitus, and 1 group at risk for small gestational age), from which 9 and 7 were respectively performed in the second and third trimesters. Most of the evaluations considered both hypocoiling and hypercoiling. The sensitivity, specificity, and area under curves (AUCs) change range between the evaluations were 0.09–0.97, 0.59–0.96, and 0.262–0.84, respectively. Conclusion: Observing any coiling abnormalities in every trimester, both the second and third, is highly sensitive to predicting abnormal postnatal UCI (pUCI). Conclusively, any detected antenatal abnormality is worth attention. Both trimesters' evaluations are essential, and no superiority is seen for any of them. The systematic review revealed statistical and clinical heterogeneity; a meta-analysis was impossible.",

keywords = "antenatal, diagnostic accuracy study, postnatal, prediction, ultrasound assessment, umbilical coiling index",

author = "Leila Ghalichi and Ghadikolaei, {Omolbanin Asadi} and Nazanin Hosseinkhan and Azadeh Abedini and Shahnaz Ahmadi and Laily Najafi",

note = "Funding Information: This study was funded and supported by the Iran University of Medical Sciences (IUMS); Grant No. 98‐1‐37‐14773. The authors wish to thank the staff of the Endocrine Research Center, who immensely helped us to complete the project. Publisher Copyright: {\textcopyright} 2023 Japan Society of Obstetrics and Gynecology.",

year = "2023",

month = aug,

day = "28",

doi = "10.1111/jog.15781",

language = "English",

journal = "Journal of Obstetrics and Gynaecology Research",

issn = "1341-8076",

publisher = "Wiley",

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TY - JOUR

T1 - Prediction of postnatal abnormal umbilical cord coiling by antenatal evaluation in pregnant women: Diagnostic accuracy study

T2 - a systematic review

AU - Ghalichi, Leila

AU - Ghadikolaei, Omolbanin Asadi

AU - Hosseinkhan, Nazanin

AU - Abedini, Azadeh

AU - Ahmadi, Shahnaz

AU - Najafi, Laily

N1 - Funding Information: This study was funded and supported by the Iran University of Medical Sciences (IUMS); Grant No. 98‐1‐37‐14773. The authors wish to thank the staff of the Endocrine Research Center, who immensely helped us to complete the project. Publisher Copyright: © 2023 Japan Society of Obstetrics and Gynecology.

PY - 2023/8/28

Y1 - 2023/8/28

N2 - Study Objective: Umbilical cord abnormalities increase neonatal morbidity and mortality. Considering uncertainties about the best time of an antenatal ultrasonography scan to evaluate the umbilical coiling index (UCI), this systematic review was designed to assess the diagnostic accuracy value of antenatal ultrasound assessments to predict abnormal postpartum UCI. Methods: All observational, cross-sectional, case–control, cohort, and diagnostic accuracy studies up to March 26, 2022, were searched and assessed according to PRISMA guidelines in Ovid, Cochrane, Scopus, PubMed, Web of Science, Embase, Proquest, Science Direct, and Clinical Key databases, and Google Scholar search engine. Results: The total number of 63 190 documents were retrieved from databases. The duplicates (19 272) were removed, 43 918 articles were screened for relevance, and 56 papers were selected for full-text evaluation, resulting in 14 qualified pieces subjected to the quality CASP tools for each type of study. Finally, six articles were evaluated, extracted, and confirmed. Overall, we had 16 evaluations (11 normal pregnancies, 4 gestational diabetes mellitus, and 1 group at risk for small gestational age), from which 9 and 7 were respectively performed in the second and third trimesters. Most of the evaluations considered both hypocoiling and hypercoiling. The sensitivity, specificity, and area under curves (AUCs) change range between the evaluations were 0.09–0.97, 0.59–0.96, and 0.262–0.84, respectively. Conclusion: Observing any coiling abnormalities in every trimester, both the second and third, is highly sensitive to predicting abnormal postnatal UCI (pUCI). Conclusively, any detected antenatal abnormality is worth attention. Both trimesters' evaluations are essential, and no superiority is seen for any of them. The systematic review revealed statistical and clinical heterogeneity; a meta-analysis was impossible.

AB - Study Objective: Umbilical cord abnormalities increase neonatal morbidity and mortality. Considering uncertainties about the best time of an antenatal ultrasonography scan to evaluate the umbilical coiling index (UCI), this systematic review was designed to assess the diagnostic accuracy value of antenatal ultrasound assessments to predict abnormal postpartum UCI. Methods: All observational, cross-sectional, case–control, cohort, and diagnostic accuracy studies up to March 26, 2022, were searched and assessed according to PRISMA guidelines in Ovid, Cochrane, Scopus, PubMed, Web of Science, Embase, Proquest, Science Direct, and Clinical Key databases, and Google Scholar search engine. Results: The total number of 63 190 documents were retrieved from databases. The duplicates (19 272) were removed, 43 918 articles were screened for relevance, and 56 papers were selected for full-text evaluation, resulting in 14 qualified pieces subjected to the quality CASP tools for each type of study. Finally, six articles were evaluated, extracted, and confirmed. Overall, we had 16 evaluations (11 normal pregnancies, 4 gestational diabetes mellitus, and 1 group at risk for small gestational age), from which 9 and 7 were respectively performed in the second and third trimesters. Most of the evaluations considered both hypocoiling and hypercoiling. The sensitivity, specificity, and area under curves (AUCs) change range between the evaluations were 0.09–0.97, 0.59–0.96, and 0.262–0.84, respectively. Conclusion: Observing any coiling abnormalities in every trimester, both the second and third, is highly sensitive to predicting abnormal postnatal UCI (pUCI). Conclusively, any detected antenatal abnormality is worth attention. Both trimesters' evaluations are essential, and no superiority is seen for any of them. The systematic review revealed statistical and clinical heterogeneity; a meta-analysis was impossible.

KW - antenatal

KW - diagnostic accuracy study

KW - postnatal

KW - prediction

KW - ultrasound assessment

KW - umbilical coiling index

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DO - 10.1111/jog.15781

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SN - 1341-8076

JO - Journal of Obstetrics and Gynaecology Research

JF - Journal of Obstetrics and Gynaecology Research

ER -

Prediction of postnatal abnormal umbilical cord coiling by antenatal evaluation in pregnant women: Diagnostic accuracy study: a systematic review

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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