Treatment of Placenta Increta With High-Intensity Focused Ultrasound Ablation and Leaving the Placenta in situ: A Multicenter Comparative Study

作者全名："Guan, Xiaoping; Huang, Xiaoqin; Ye, Min; Huang, Guohua; Xiao, Xiao; Chen, Jinyun"

作者地址："[Guan, Xiaoping; Chen, Jinyun] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China; [Guan, Xiaoping; Chen, Jinyun] Chongqing Med Univ, Chongqing Key Lab Biomed Engn, Chongqing, Peoples R China; [Guan, Xiaoping; Huang, Xiaoqin; Ye, Min] Neijiang First Peoples Hosp, Dept Gynecol, Neijiang, Peoples R China; [Huang, Guohua] Suining Cent Hosp, Dept Gynecol, Suining, Peoples R China; [Xiao, Xiao; Chen, Jinyun] Chongqing Haifu Hosp, Dept Gynecol, Chongqing, Peoples R China"

通信作者："Chen, JY (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China.; Chen, JY (通讯作者)，Chongqing Med Univ, Chongqing Key Lab Biomed Engn, Chongqing, Peoples R China.; Chen, JY (通讯作者)，Chongqing Haifu Hosp, Dept Gynecol, Chongqing, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000791541200001

JCR分区：Q1

影响因子：3.9

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：placenta increta; high-intensity focused ultrasound (HIFU); focused ultrasound therapy; leaving the placenta in situ; placenta accreta spectrum; abnormally invasive placentation

摘要："ObjectiveTo explore the feasibility of simple high-intensity focused ultrasound (HIFU) ablation for placenta increta. MethodsNinety-five patients after a vaginal delivery were enrolled in this retrospective cohort study, 53 patients were treated with simple HIFU ablation, and 42 patients were treated with HIFU followed by uterine curettage. ResultsAll 95 patients were successfully treated with a single-session HIFU procedure, and in the control group, the necrotic placental tissue was removed with curettage. Vaginal hemorrhage did not occur in either group. The duration of bloody lochia was 25.9 +/- 8.6 days in the sHIFU group and 24.2 +/- 8.8 days in the control group (P > 0.05). The median serum human chorionic gonadotropin (HCG) level was 3,222 mIU/mL and 2,838 mIU/mL in the sHIFU and control groups, respectively, which decreased and returned to normal within 30 days, and the differences were not significantly on comparing the blood HCG level in the two groups at 7, 15, and 30 days after HIFU (all P > 0.05). Decreased menstrual volume occurred in 85.71% of patients in the control group, which was higher than that in the sHIFU group (23.08%) (chi(2) = 6.839, P < 0.001). During 2-8 years of follow-up, six pregnancies occurred in the sHIFU group without any recurrence of placenta increta, three pregnancies occurred in the control group, and one patient developed a repeat placenta increta. ConclusionSimple HIFU treatment is safe and effective for postpartum placenta increta and leaving the placenta in situ. It is a promising option for patients who wish to preserve their fertility and conceive."

基金机构：Chongqing Mentor Team Construction Project of Chongqing Municipal Education Commission [dstd201810]

基金资助正文：Funding This study was supported by the Chongqing Mentor Team Construction Project of Chongqing Municipal Education Commission (No. dstd201810).