The effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder

作者全名："Yuan, Yuan; He, Xian; Liu, Ping; Pu, Dali; Shi, Qiuling; Chen, Jinyun; Teichmann, Alexander T.; Zhan, Ping"

作者地址："[Yuan, Yuan; He, Xian; Liu, Ping; Pu, Dali; Teichmann, Alexander T.; Zhan, Ping] Southwest Med Univ, Affiliated Hosp, Sichuan Prov Ctr Gynaecol & Breast Dis, 25 Taiping St, Luzhou 646000, Sichuan, Peoples R China; [Yuan, Yuan; Shi, Qiuling; Chen, Jinyun] Chongqing Med Univ, State Key Lab Ultrasound Med & Engn, Chongqing 400016, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing 400016, Peoples R China"

通信作者："Zhan, P (通讯作者)，Southwest Med Univ, Affiliated Hosp, Sichuan Prov Ctr Gynaecol & Breast Dis, 25 Taiping St, Luzhou 646000, Sichuan, Peoples R China."

来源：ARCHIVES OF GYNECOLOGY AND OBSTETRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000899708900001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：307

期号：4

开始页：1037

结束页：1045

文献类型：Article

关键词：High-intensity focused ultrasound; Placenta accrete; Placenta increta; Placenta percreta

摘要："Objective To evaluate the feasibility and effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder.Materials and methods We retrospectively analyzed 40 PAS patients between April 2017 and October 2021. All the patients received one session of HIFU treatment. Regular follow-up was done after HIFU treatment until normal menstruation returned and placental tissue disappeared. The patient's reproductive-related outcomes were obtained through telephone interviews.Results The median follow-up time for the 40 patients was 30.50 (15.75-44.00) months and the mean placental tissue elimination time was 45.29 +/- 33.32 days. The mean duration of bloody lochia was 13.43 +/- 10.01 days, with no incidences of severe bleeding. Notably, Linear regression analysis showed that the residual placenta volume before HIFU was a factor affecting the duration of bloody lochia after HIFU (R2 = 0.284, B = 0.062, P = 0.000). The normal menstrual return time was 58.71 +/- 31.14 days. One (2.50%) patient developed an infection. Two (5.00%) patients were subjected to ultrasound-guided suction curettage for persistent vaginal discharge for more than one month without infection. Notably, 7 of the 18 patients who expressed reproductive plans became pregnant during the 4 to 53 months of follow-up without placental abnormalities. The remaining 11 patients were on contraceptives.Conclusions Single HIFU is an effective treatment option for managing PAS. However, future studies on further treatment strategies to reduce complications and promote patient recovery after HIFU ablation are desirable."

基金机构："Southwest Medical University of Sichuan Province, China [(2018)-ZRQN-091]"

基金资助正文："This project was funded by the Southwest Medical University of Sichuan Province, China [(2018)-ZRQN-091]."