The Feasiability Study Of Hifu Followed By Curettage In The Treatment Of Placenta Accreta

Objective:To investigate the feasiability of high intensity focused ultrasound followed by curettage for the treatment of placenta accreta.Methods:From June 2012 to March 2015, seventeen patients with placenta accreta from Suining Central Hospital were enrolled in this study. All the seventeen patients were treated with ultrasound guided HIFU followed by curettage at three to fourteen days after HIFU. The blood loss during curettage, the complications, the decline of blood β-hCG, menstrual cramps after the operation were recorded.Results:(1) The HIFU procedure was successfully performed in all the seventeen patients. The contrast-enhanced ultrasound (CEUS) showed that there was no blood perfusion in placenta tissues immediately after HIFU;(2) Among them, sixteen cases had successful curettage, except one one case who received the second session of HIFU treatment because of the failure of curettage after the first session of HIFU;(3) Except for one fever after HIFU, the other sixteen cases got no major adverse effects or complications during and after operations;(4) Compared with the patients without pre-treatment with HIFU, the bleeding during curettage decreased significantly(P<0.05);(5) During follow-up, the blood β-hCG of all the seventeen patients significantly reduced or decreased to normal seven to nineteen days later, the size of uterus returned to normal two to three months later, and the cycle of menstruation returned to normal two to ten months later.Conclusions:(1) High intensity focused ultrasound followed by curettage is safe and feasible in the management of patients with placenta accreta;(2) Pre-treatment with HIFU could decrease the incidence of major adverse effects or serious complications during the curettage, and preserve the patients reproductive function.