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- Title
Anatomical and functional changes in arteries of uterine circulation after modified laparoscopic transabdominal cerclage in pregnancy: A case report and review of the literature.
- Authors
Nemescu, Dragos; Tanasa, Ingrid Andrada; Bohiltea, Roxana Elena; Coroleuca, Ciprian; Bratila, Elvira; Vinturache, Angela Elena
- Abstract
Modified laparoscopic transabdominal cerclage (LTAC) was developed as a safer approach for the treatment of cervical insufficiency in pregnancy, with the cerclage tape placed lateral to the uterine vessels. We describe and review the evolution of a woman who successfully underwent an LTAC at 12 weeks of gestation, whose fetus developed growth retardation after 32 weeks. Three-dimensional power Doppler reconstruction viewed both uterine arteries (UtAs) inside of the cerclage until the second trimester. Thereafter, the visualization of UtAs showed the development of a rich array of collateral vascularization, adaptation supported by the findings of low velocity and pulsatility of blood flow in the UtAs. The appearance of the UtAs varies throughout the gestation. There is a moderate variation of the shape and curvature that could result due to their elongation. Furthermore, the cervical length increased during gestation, from 20 to 30 mm. We speculate that this is a mechanical modeling during the late gestation. More studies are needed to understand the hemodynamic and mechanical effects as well as the impact on fetal growth and development of modified LTAC in women with a short cervix or cervical incompetence.
- Subjects
UTERINE artery; FETAL growth retardation; LITERATURE reviews; UTERINE cervix incompetence; BLOOD flow
- Publication
Experimental & Therapeutic Medicine, 2020, Vol 20, Issue 3, p2465
- ISSN
1792-0981
- Publication type
Article