Clinical Research On Color Doppler Ultrasonography-guided Anhydrous Ethanol Injection Therapy Of Placental Implantation

Objective: To explore the clinical effect of Color Doppler Ultrasonography-guided Anhydrous Ethanol Injection Therapy of Placental Implantation.To evaluate the clinical safety,efficacy and application value in the treatment.In order to find out approaches for the placental implantation both preserve fertility as well as treat effectively.Materials and Methods: From January 2009 to May 2017,34 cases with placental implantation were selected as the subjects of study,including 34 cases of abortion,labor induction and post-partum diagnosis of placental implantation in our hospital,the clinical datas were analyzed.The average age was(30.4±5.1)years old.There were abortion and induced labor induction in the past,17 of them had a history of cesarean section.The pregnancy: 15 cases of early pregnancy abortion,13 cases of middle pregnancy abortion,13 cases of induced labor induction,2 cases of late pregnancy induced labor induction,2 cases of natural labor and 2 cases of cesarean section;Blood ?-HCG range 0.1-99042 m IU/ml,the area of intrauterine placental tissue was 20mm×17mm-98mm×58mm,and there were rich blood flow signals in 21 cases of placental implantation site.Local injection of anhydrous ethanol into placenta under the guidance of Color Doppler Ultrasonography in 34 patients,according to the value of blood ?-HCG,the range of placental implantation and the blood flow signals,the bleeding during and after operation was recorded,and the occurrence of complications during and after operation was noted.Blood ?-HCG was monitored after operation,and the tissue and blood flow signals of intrauterine placenta were observed by Color Doppler Ultrasonography.Postoperative follow-up of ?-HCG in blood,imaging examination of uterus(mainly Color Doppler Ultrasonography),menorrhagia and re-pregnancy,etc.Results: The therapeutic effects of thirty-four patients are remarkable.Before the treatment 28 patients' serum ?-HCG was higher.After the treatment the average descending amount in ?-HCG was respectively 1277.4± 4966.3ml U/ml and 769.0± 2187.7ml U/ml within 1 week,2 weeks and 3 weeks.The rates were 89%,91% and 93% respectively.The placenta tissue shrank gradually.Within 3 months and 6 months the placenta tissue disappeared,which accounted for 25% and 40% respectively.The areas of residual placenta tissue were reduced by 74% and 77% respectively in 3 months and 6 months.After the first day of the treatment,the vaginal bleeding of 13 patients stopped and 19 cases significantly decreased.After one injection,the termination of vaginal bleeding in a week was 31 cases,accounted for 91%;After two injections,the termination of vaginal bleeding in a week was 2 cases,accounted for 6%;After three injections,the termination of vaginal bleeding in a week was 1 case,accounted for 3%.No serious complications were achieved in the 34 patients.During the 6 months' follow-up visit after the treatment,34 patients' menstruation recovered to normal.13 patients were pregnant again.Conclusions: Color Doppler Ultrasonography-guided Anhydrous Ethanol Injection Therapy of Placental Implantation is a newfashioned and valid treatment for placenta accreta,which possesses safety,efficacy and clinical value.