Retained Placenta

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Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with retained placenta. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.

How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue), enabling retained placenta to be treated without surgery. While there have been some human treatments, further research is needed before this can become widely available.

Advantages
The primary options for treatment of retained placenta include surgery.

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.

Clinical Trials

clinical trial is being organized in France to treat patients with placenta accreta who are having a caesarian section.

Regulatory Approval and Reimbursement

Focused ultrasound treatment for retained placenta is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

Yuan Y, He X, Liu P, Pu D, Shi Q, Chen J, Teichmann AT, Zhan P. The effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder. Arch Gynecol Obstet. 2023 Apr;307(4):1037-1045. doi: 10.1007/s00404-022-06840-6. Epub 2022 Dec 16.

Chen H, Tan X, Xiong W, Wang X. High-intensity-focused ultrasound for uterine arteriovenous malformation associated with retained products of conception: A case report. Asian J Surg. 2023 Jan;46(1):653-654. doi: 10.1016/j.asjsur.2022.07.026. Epub 2022 Jul 22.

Yuan Y, He X, Liu P, Pu D, Shi Q, Chen J, Teichmann AT, Zhan P. The effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder. Arch Gynecol Obstet. 2022 Dec 16. doi: 10.1007/s00404-022-06840-6.

Lin Z, Gong C, Huang Q, Zhang Z, Wang D, Yuan L, Wang X, An Q, Chen D, Liu S, Zou X, Setzen R, Yang B, Zhang L. A comparison of results following the treatment of placenta accreta and placenta increta using high-intensity focused ultrasound followed by hysteroscopic resection. Int J Hyperthermia. 2021;38(1):576-581. doi: 10.1080/02656736.2021.1909149.

He S, Xue M, Jiang J. Early versus late hysteroscopic resection after high-intensity focused ultrasound for retained placenta accreta. Int J Hyperthermia. 2021;38(1):257-262. doi: 10.1080/02656736.2021.1887943.

Elazeem HASA, Saad MM, Ahmed IA, Sayed EG, AlMahdy AM, Atef F, Elassall GM, Ashraf Salah M, Ali AK, Ragab EY, Shazly SA; Middle-East Obstetrics, Gynecology Graduate Education (MOGGE) Foundation Research Committee. High intensity focused ultrasound in management of placenta accreta spectrum: A systematic review. Int J Gynaecol Obstet. 2020 Sep 25. doi: 10.1002/ijgo.13391.

Jiang X, Tang Q, Yang B, Ye F, Cai L, Wang X, Luo X, Bu H. High-intensity focused ultrasound combined procedures treatment of retained placenta accreta with marked vascularity after abortion or delivery. Int J Hyperthermia. 2019 Mar 20:1-7. doi: 10.1080/02656736.2019.1581279.

Ye M, Yin Z, Xue M, Deng X. High-intensity focused ultrasound combined with hysteroscopic resection for the treatment of placenta accreta. BJOG. 2017 Aug;124 Suppl 3:71-77. doi: 10.1111/1471-0528.14743.

Caloone J, Huissoud C, Kocot A, Vincenot J, Dehay C, Giroud P, Misery P, Allias F, Rudigoz RC, Melodelima D. Non-invasive high-intensity focused ultrasound treatment of the placenta: a preliminary in-vivo study using a simian model. Ultrasound Obstet Gynecol. 2017 Nov;50(5):635-641. doi: 10.1002/uog.17350. Epub 2017 Oct 9.

Lee JS, Hong GY, Park BJ, Hwang H, Kim R, Kim TE. High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta. Obstet Gynecol Sci. 2016 Sep;59(5):421-5. doi: 10.5468/ogs.2016.59.5.421. Epub 2016 Sep 13.

Bai Y, Luo X, Li Q, Yin N, Fu X, Zhang H, Qi H. High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study. Ultrasound Obstet Gynecol. 2016 Apr;47(4):492-8. doi: 10.1002/uog.14867. Epub 2016 Mar 6.

Click here for additional references from PubMed.

Clinical Trials