High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta.
We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure. After HIFU treatment, no additional vaginal bleeding or complications were observed. A hysteroscopic resection was performed to remove ablated placental tissue 7 days later. No abnormal vaginal bleeding or discharge was seen after the procedure. The patient was stable postoperatively. We proposed HIFU and applied additional hysteroscopic resection for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.
Aegis Woman Medical Clinic, Seoul, Korea.
Jae-Seong
JS
Lee
Green Cross Medical Clinic, Incheon, Korea.
Gi-Youn
GY
Hong
Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Byung-Joon
BJ
Park
Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Hyejin
H
Hwang
Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Rayon
R
Kim
Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Tae-Eung
0000-0003-1208-7740
TE
Kim
High-intensity focused ultrasound ablation; Hysteroscopic resection; Retained placenta accrete
J Minim Invasive Gynecol. 2011 Nov-Dec;18(6):774-8
22024264
Radiology. 2012 May;263(2):600-9
22403170
Obstet Gynecol. 2012 Jul;120(1):207-11
22914422
Am Surg. 2011 Nov;77(11):1496-501
22196664
J Gastrointest Oncol. 2011 Sep;2(3):175-84
22811848
Acta Obstet Gynecol Scand. 2005 May;84(5):444-7
15842208
Eur J Surg Oncol. 2010 Dec;36(12 ):1149-55
20889281
Eur Radiol. 2004 Jun;14(6):945-52
15045519
Ultrasound Obstet Gynecol. 2014 Jan;43(1):98-101
23836523
Am J Obstet Gynecol. 2003 Sep;189(3):702-5
14526297
Br J Radiol. 2003 Sep;76(909):590-9
14500272
Am J Obstet Gynecol. 2014 Oct;211(4):356.e1-7
24769010
J Minim Invasive Gynecol. 2006 Jul-Aug;13(4):342-4
16825079
J Minim Invasive Gynecol. 2014 Sep-Oct;21(5):910-3
24768979
Geburtshilfe Frauenheilkd. 2014 Feb;74(2):139-145
24741124