High‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review. Issue 3 (4th November 2020)

• Record Type: Journal Article
• Authors: Abd Elazeem, Hossam Aldein S.; Saad, Mahmoud M.; Ahmed, Islam A.; Sayed, Esraa G.; AlMahdy, AlBatool M.; Atef, Fatma; Elassall, Gena M.; Ashraf Salah, Mohamed; Ali, Ahmed K.; Ragab, Esraa Y.; Shazly, Sherif A.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 151:Issue 3(2020)
• Page Start: 325
• Page End: 332
• Publication Date: 2020-11-04
• Subjects: Cesarean hysterectomy -- Conservative management -- Increta -- Morbidly adherent placenta -- Percreta; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13391
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Background: High‐intensity focused ultrasound (HIFU) is a non‐invasive procedure that has been studied in the management of placenta accreta spectrum (PAS). Objective: To appraise HIFU in the management of PAS and highlight the restrictions on converting uterus‐preserving studies into evidence‐based practice. Search strategy: A search on Scopus, Cochrane, PubMed and Web of Science was conducted from date of inception to January 2020. Selection criteria: Studies on using HIFU in the management of PAS were eligible. Review articles, conference papers, and case reports were excluded. Data collection: A standardized sheet was used to abstract data from eligible studies. CON‐PAS registry was used to include studies on other conservative modalities. Results: Four studies were eligible (399 patients). Average residual placental volume was 61.74 cm 3 (6.01–339 cm 3 ). Treatment was successful in all patients. Normal menstruation recovered after 48.8 days (15–150 days). No major complications were encountered. Sixty‐one studies were retrieved from the CON‐PAS registry; uterine artery embolization (23 studies), balloon placement (15 studies), compression sutures (10 studies), placenta in situ (7 studies), and uterine resection (6 studies) were successful in 83.7%, 92.9%, 87.9%, 85.2%, and 79.3% of cases, respectively. Conclusions: HIFU may fit certain clinical situations in the management of PAS. A global research strategy is recommended to incorporate conservative approaches within a comprehensive management protocol. Synopsis: High‐intensity focused ultrasound may fit certain clinical situations in the management of placenta accreta spectrum.