Anatomical and functional changes in arteries of uterine circulation after modified laparoscopic transabdominal cerclage in pregnancy: A case report and review of the literature

Nemescu,Dragos; Tanasa,Ingrid   Andrada; Bohiltea,Roxana   Elena; Coroleuca,Ciprian; Bratila,Elvira; Vinturache,Angela   Elena

doi:10.3892/etm.2020.8807

September-2020 Volume 20 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

September-2020 Volume 20 Issue 3

Full Size Image

Case Report Open Access

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:
- Dragos Nemescu
- Ingrid Andrada Tanasa
- Roxana Elena Bohiltea
- Ciprian Coroleuca
- Elvira Bratila
- Angela Elena Vinturache
View Affiliations / Copyright

Affiliations: Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Obstetrics and Gynecology, Queen Elizabeth II Hospital, Grande Prairie, AB T8V 2E8, Canada

Copyright: © Nemescu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 2465-2469
|
Published online on: May 28, 2020

https://doi.org/10.3892/etm.2020.8807
Expand metrics +

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.

View Figures

View References

1	Clark NV and Einarsson JI: Laparoscopic abdominal cerclage: A highly effective option for refractory cervical insufficiency. Fertil Steril. 113:717–722. 2020.PubMed/NCBI View Article : Google Scholar
2	Shennan A, Chandiramani M, Bennett P, David AL, Girling J, Ridout A, Seed PT, Simpson N, Thornton S, Tydeman G, et al: MAVRIC: A multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage. Am J Obstet Gynecol. 222:261.e1–261.e9. 2020.PubMed/NCBI View Article : Google Scholar
3	Ades A, Dobromilsky KC, Cheung KT and Umstad MP: Transabdominal cervical cerclage: Laparoscopy versus laparotomy. J Minim Invasive Gynecol. 22:968–973. 2015.PubMed/NCBI View Article : Google Scholar
4	Shin SJ, Chung H, Kwon SH, Cha SD, Lee HJ, Kim AR, Hwang I and Cho CH: The feasibility of a modified method of laparoscopic transabdominal cervicoisthmic cerclage during pregnancy. J Laparoendosc Adv Surg Tech A. 25:651–656. 2015.PubMed/NCBI View Article : Google Scholar
5	Karagiannis G, Akolekar R, Sarquis R, Wright D and Nicolaides KH: Prediction of small-for-gestation neonates from biophysical and biochemical markers at 11-13 weeks. Fetal Diagn Ther. 29:148–154. 2011.PubMed/NCBI View Article : Google Scholar
6	O'Gorman N, Wright D, Syngelaki A, Akolekar R, Wright A, Poon LC and Nicolaides KH: Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation. Am J Obstet Gynecol. 214:103.e101–103.e112. 2016.PubMed/NCBI View Article : Google Scholar
7	Nicolaides KH, Wright D, Syngelaki A, Wright A and Akolekar R: Fetal Medicine Foundation fetal and neonatal population weight charts. Ultrasound Obstet Gynecol. 52:44–51. 2018.PubMed/NCBI View Article : Google Scholar
8	Ichizuka K, Seo K, Dohi S, Ishikawa T, Sekizawa A and Nagatsuka M: Three-dimensional ultrasound imaging of intra-abdominal cervical-isthmus cerclage. Ultrasound Obstet Gynecol. 51:704–705. 2018.PubMed/NCBI View Article : Google Scholar
9	Nemescu D, Navolan DB and Veduta A: Spatial configuration of the uterine artery cervical segment in 3-dimensional reconstruction at 11 to 14 weeks' gestation. J Ultrasound Med. 37:2717–2720. 2018.PubMed/NCBI View Article : Google Scholar
10	Seo K, Dohi S, Ishikawa T, Ichizuka K, Sekizawa A and Nagatsuka M: Modified laparoscopic cervicoisthmic cerclage in early pregnancy for refractory cervical incompetence: A case report. J Obstet Gynaecol Res. 45:1597–1602. 2019.PubMed/NCBI View Article : Google Scholar
11	Whittle WL, Singh SS, Allen L, Glaude L, Thomas J, Windrim R and Leyland N: Laparoscopic cervico-isthmic cerclage: Surgical technique and obstetric outcomes. Am J Obstet Gynecol. 201:364.e361–367. 2009.PubMed/NCBI View Article : Google Scholar
12	Moawad GN, Tyan P, Awad C and Abi Khalil ED: Surgical variance between postconceptional and preconceptional minimally invasive transabdominal cerclage placement. Am J Obstet Gynecol. 219:414.e411–414.e412. 2018.PubMed/NCBI View Article : Google Scholar
13	Foster TL, Moore ES and Sumners JE: Operative complications and fetal morbidity encountered in 300 prophylactic transabdominal cervical cerclage procedures by one obstetric surgeon. J Obstet Gynaecol. 31:713–717. 2011.PubMed/NCBI View Article : Google Scholar
14	Kofinas AD, Penry M, Greiss FC Jr, Meis PJ and Nelson LH: The effect of placental location on uterine artery flow velocity waveforms. Am J Obstet Gynecol. 159:1504–1508. 1988.PubMed/NCBI View Article : Google Scholar
15	Tamada S, Masuyama H, Hayata K, Eto E, Mitsui T, Eguchi T, Maki J and Tani K: Successful delivery after abdominal radical trachelectomy, using transabdominal cerclage in early pregnancy. Acta Med Okayama. 73:173–176. 2019.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Anatomical and functional changes in arteries of uterine circulation after modified laparoscopic transabdominal cerclage in pregnancy: A case report and review of the literature

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles