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

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

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.

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Funding

This project was funded by the Southwest Medical University of Sichuan Province, China [(2018)-ZRQN-091].

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Authors and Affiliations

  1. Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China

    Yuan Yuan, Xian He, Ping Liu, Dali Pu, Alexander T. Teichmann & Ping Zhan

  2. State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, China

    Yuan Yuan, Qiuling Shi & Jinyun Chen

  3. School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China

    Qiuling Shi

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  1. Yuan Yuan
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Contributions

All authors contributed to the study’s conception and design. The integrity of the entire study was guaranteed by PZ. YY, XH, PL, and DP executed the study and collected the data. QS performed the data analysis. YY wrote the first draft of the manuscript which was reviewed by all the other authors. All authors read and approved the final manuscript. All authors contributed to the study’s conception and design.

Corresponding author

Correspondence to Ping Zhan.

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Competing interests

The authors have no relevant financial or non-financial interests to disclose. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethics approval

This study was performed according to the guidelines of the Helsinki declaration and was approved by the Ethics Committee of Southwest Medical University (No.: KY2022151).

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Informed consent was obtained from all participants included in the study.

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The authors affirm that human research participants provided informed consent for the publication of the images in Figs. 1, 2, 3, and 4.

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Yuan, Y., He, X., Liu, P. et al. The effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder. Arch Gynecol Obstet 307, 1037–1045 (2023). https://doi.org/10.1007/s00404-022-06840-6

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