Abstract：
To evaluate the feasibility and effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder.
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.
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.
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.
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.
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.
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.
摘要：
目的：评估单次超声引导下高强度聚焦超声（USgHIFU）消融治疗胎盘植入频谱（PAS）障碍的可行性和有效性。
方法：我们回顾性分析了2017年4月至2021年10月期间的40例PAS患者。所有患者均接受一次HIFU治疗。HIFU治疗后定期随访，直至月经恢复正常，胎盘组织消失。患者的生殖相关结局是通过电话采访获得的。
结果：40例患者的中位随访时间为30.50（15.75-44.00）个月，平均胎盘组织消除时间为45.29±33.32天。血恶露的平均持续时间为13.43±10.01天，没有严重出血的发生率.值得注意的是,线性回归分析显示,HIFU前胎盘残存量是影响HIFU后血恶露持续时间的因素(R2=0.284,B=0.062,P=0.000)。正常月经恢复时间为58.71±31.14天。1例（2.50%）患者出现感染。两名（5.00％）患者接受了超声引导下的吸引刮刮术，持续存在超过一个月的阴道分泌物而没有感染。值得注意的是,18位表达生殖计划的患者中有7位在4至53个月的随访中怀孕，没有胎盘异常。其余11名患者服用避孕药。
结论：单一HIFU是管理PAS的有效治疗选择。然而,希望进一步研究HIFU消融术后减少并发症和促进患者康复的治疗策略.
方法：我们回顾性分析了2017年4月至2021年10月期间的40例PAS患者。所有患者均接受一次HIFU治疗。HIFU治疗后定期随访，直至月经恢复正常，胎盘组织消失。患者的生殖相关结局是通过电话采访获得的。
结果：40例患者的中位随访时间为30.50（15.75-44.00）个月，平均胎盘组织消除时间为45.29±33.32天。血恶露的平均持续时间为13.43±10.01天，没有严重出血的发生率.值得注意的是,线性回归分析显示,HIFU前胎盘残存量是影响HIFU后血恶露持续时间的因素(R2=0.284,B=0.062,P=0.000)。正常月经恢复时间为58.71±31.14天。1例（2.50%）患者出现感染。两名（5.00％）患者接受了超声引导下的吸引刮刮术，持续存在超过一个月的阴道分泌物而没有感染。值得注意的是,18位表达生殖计划的患者中有7位在4至53个月的随访中怀孕，没有胎盘异常。其余11名患者服用避孕药。
结论：单一HIFU是管理PAS的有效治疗选择。然而,希望进一步研究HIFU消融术后减少并发症和促进患者康复的治疗策略.
