VP35.06: Anatomical and functional changes of the uterine arteries after modified laparoscopic transabdominal cerclage in pregnancy: a case report

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 report a case of a woman who successfully underwent an LTAC at 12 weeks of gestation, whose fetus developed late-onset growth retardation after 32 weeks. We evaluated the uterine arteries pathway at the level of the abdominal cerclage using 3D power Doppler reconstruction. Both uterine arteries can be visualised inside of the cerclage ring until the second trimester. Later, at least one was patent, with a typical pathway until delivery. There is a moderate variation of the shape and curvature that could result due to the arteries' elongation. Starting with 16 gestational weeks, the visualisation of uterine arteries showed the development of a rich vascularisation surrounding the uterine artery, adaptation supported by the findings of low velocity and pulsatility of the blood flow in the uterine arteries. Furthermore, the cervical length increased during gestation. Modified LTAC can be proposed as one of the treatment options for pregnant patients with cervical incompetence. However, we need more studies to assess the effect of the modified LTAC on fetal development. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.