{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:09:49Z","timestamp":1782439789284,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2017,8,30]],"date-time":"2017-08-30T00:00:00Z","timestamp":1504051200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the safety and efficacy of a combination of high\u2010intensity focused ultrasound (<jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content>) and hysteroscopic resection while treating placenta accreta (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A university teaching hospital in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 25 patients diagnosed with <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> who underwent <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> followed by hysteroscopic resection in our hospital between January 2014 and December 2015. All patients had completed follow\u2010up data. Treatment efficacy and safety were evaluated retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Placenta accreta could be removed with hysteroscopic resection after <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients received one session of <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> ablation therapy. The median total <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> treatment time was 18\u00a0minutes and the median exposure time was 600\u00a0seconds. During treatment, 23 lesions showed massive grey\u2010scale changes and two lesions modest grey\u2010scale change. Contrast\u2010enhanced ultrasound showed signs of reduced perfusion in all lesions. During treatment, all patients tolerated the <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> procedure well and completed the treatment. All patients complained of mild lower abdominal and sacrococcygeal pain, with a pain score ranging from 1 to 4 points. Seven patients complained of a \u2018hot\u2019 skin sensation. No serious complications were encountered during or after the procedure. All patients received hysteroscopic operations with a median of 2\u00a0days after <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> treatment. The average depth of the uterus was 10.36\u00a0\u00b1\u00a02.14\u00a0cm. The median volume of intraoperative blood loss was 20\u00a0ml, and no blood transfusions were given. Sixteen patients underwent only one session of hysteroscopic resection and nine patients underwent a second session of hysteroscopic resection operation 11\u201361\u00a0days after the first operation. All patients preserved their uterus and tolerated the hysteroscopic operation well. Of the 25 patients, two had uterine perforation during the first operation. No other severe hysteroscopic complication was observed. The average hospital stay was 8.4\u00a0\u00b1\u00a01.6\u00a0days. After treatment the median duration of vaginal bleeding was 10\u00a0days. Twenty\u2010one patients recovered normal menstruation 34\u00a0days after the operation. The other four patients continued breastfeeding and therefore exhibited abnormal menstruation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> treatment followed by hysteroscopic resection is safe and effective in treating patients with <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>For patients with placenta accreta, <jats:styled-content style=\"fixed-case\">HIFU<\/jats:styled-content> treatment before hysteroscopic resection could help reduce risk during the procedure of hysteroscopic resection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14743","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T22:33:52Z","timestamp":1504305232000},"page":"71-77","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["High\u2010intensity focused ultrasound combined with hysteroscopic resection for the treatment of placenta accreta"],"prefix":"10.1111","volume":"124","author":[{"given":"M","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Third Xiangya Hospital of Central South University Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Third Xiangya Hospital of Central South University Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Third Xiangya Hospital of Central South University Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Third Xiangya Hospital of Central South University Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000219750.79480.84"},{"key":"e_1_2_11_3_1","first-page":"1","article-title":"Births: preliminary data for 2011","volume":"61","author":"Hamilton BE","year":"2012","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e3182685870"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.04.004"},{"key":"e_1_2_11_6_1","first-page":"169","article-title":"Committee opinion no. 529: placenta accreta","volume":"120","author":"Practice COO","year":"2012","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.594467"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.598585"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.09.013"},{"key":"e_1_2_11_10_1","first-page":"761","article-title":"MRI predictors of clinical success in MR\u2010guided focused ultrasound (MRgFUS) treatments of uterine fibroids: results from a single centre","volume":"25","author":"Mindjuk I","year":"2014","journal-title":"Eur Radiol"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2013.11.011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2011.05.036"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000854"},{"key":"e_1_2_11_14_1","first-page":"12","article-title":"Placenta accreta; 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