Abstract

Objective

To compare the safety and efficacy of high-intensity focused ultrasound (HIFU) followed by hysteroscopic resection for different placenta accreta spectrum disorders.

Materials and methods

Thirty-four patients with placenta accreta, placenta increta, or placenta percreta were treated with USgHIFU from January 2016 to December 2019 and were retrospectively reviewed. The patients were classified into three categories according to the relationship between the trophoblastic villi and the myometrium, based on magnetic resonance imaging (MRI). Fifteen patients were classified as placenta accreta, 17 patients were classified as placenta increta, and 2 were classified as placenta percreta. All patients completed follow-up. Treatment efficacy and safety were evaluated.

Results

No significant differences in baseline characteristics and results of HIFU ablation were observed between the patients with placenta accreta and those with placenta increta. The return of HCG levels to normal was longer in patients with placenta accreta compared with patients with placenta increta, while no significant difference was observed in the amount of intraoperative blood loss, the return of normal menstruation and the length of hospital stay.

Conclusions

HIFU treatment followed by hysteroscopic resection is safe and effective in the treatment of patients with placenta accreta and placenta increta.

中文翻译：

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高强度聚焦超声然后宫腔镜切除术治疗胎盘增生和胎盘增大后的结果比较

摘要

客观的

比较高强度聚焦超声（HIFU）和宫腔镜切除术对不同胎盘增生频谱疾病的安全性和有效性。

材料和方法

自2016年1月至2019年12月，对USgHIFU治疗了34例有胎盘增生，胎盘增生或胎盘胎盘炎的患者，并进行了回顾性检查。根据磁共振成像（MRI），根据滋养细胞绒毛和子宫肌层之间的关系，将患者分为三类。15例被归类为胎盘植入，17例被归为胎盘植入，2例被归为胎盘植入。所有患者均完成随访。评价治疗效果和安全性。

结果

在有胎盘增生的患者和有胎盘增生的患者之间，基线特征和HIFU消融结果没有显着差异。与增加胎盘的患者相比，胎盘植入患者的HCG水平恢复正常的时间更长，而术中失血量，月经恢复正常和住院时间的长短均无显着差异。

结论

HIFU治疗，然后宫腔镜切除术在增生胎盘和胎盘增生患者的治疗中是安全有效的。