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Shindo R, Aoki S, Nakanishi S, Obata S, Miyagi E. Women with elevated blood pressure and stage 1 hypertension are at high risk for preeclampsia. A retrospective study at a tertiary facility in Japan. J Obstet Gynaecol Res 2024; 50:366-372. [PMID: 38081639 DOI: 10.1111/jog.15852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/27/2023] [Indexed: 03/04/2024]
Abstract
AIM In 2017, the American College of Cardiology (ACC) re-defined hypertension (HT) as follows: elevated blood pressure (EBP), systolic blood pressure (SBP) 120-129 mmHg and diastolic blood pressure (DBP) <80 mmHg; stage 1 HT, SBP 130-139 mmHg or DBP 80-89 mmHg; and stage 2 HT: SBP ≥140 mmHg or DBP ≥90 mmHg. It is well known that women with stage 2 HT are at higher risk of preeclampsia and have poorer pregnancy and delivery outcomes. While there are few reports on the risk in women with EBP and stage 1 HT, and none from Japan. This study aimed to determine whether women in Japan with EBP and stage 1 HT are at risk of preeclampsia. METHODS In this single-center retrospective study conducted in Japan, subjects were classified into stage 2 HT, stage 1 HT, EBP, and normal groups based on blood pressure measurements at the time of the first visit before 20 weeks of gestation. Women with a diagnosis of hypertension made before pregnancy were classified into the stage 2 HT group. We compared pregnancy and delivery outcomes, such as preeclampsia, between groups. RESULTS A total of 5129 cases (normal, n = 4283; EBP, n = 427; stage 1 HT, n = 303; stage 2 HT, n = 116) were included. Preeclampsia incidence rates were 2.7%, 5.6%, 10.6%, and 21.6%, respectively. The adjusted OR (95% CI) for preeclampsia incidence were 2.90 (1.81-4.66), 5.90 (3.87-9.20), and 13.80 (7.97-24.0), respectively. CONCLUSIONS Women with EBP and stage 1 HT are at high risk of preeclampsia, similar to those with stage 2 HT.
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Affiliation(s)
- Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama City, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama City, Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama City, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama City, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama City, Japan
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Hirahara Y, Yamaguchi M, Takase-Minegishi K, Kirino Y, Aoki S, Hirahara L, Obata S, Kasai M, Maeda A, Tsuchida N, Yoshimi R, Horita N, Nakajima H, Miyagi E. Pregnancy outcomes in patients with familial Mediterranean fever: systematic review and meta-analysis. Rheumatology (Oxford) 2024; 63:277-284. [PMID: 37594755 DOI: 10.1093/rheumatology/kead417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE The relationship between FMF and pregnancy outcomes remains unclear. This systematic review and meta-analysis aimed to clarify this association. METHODS Electronic databases-PubMed, Web of Science, Cochrane, and EMBASE-were searched on 20 December 2022, using specific search terms. Case-control, cohort, and randomized clinical trial studies comparing patients with FMF and healthy controls were considered eligible. We excluded systematic reviews, meta-analyses, case series with fewer than five cases, republished articles without new findings on pregnancy outcomes, studies targeting paternal FMF, and those not published in English. The results were summarized in the form of odds ratios (ORs) and 95% CIs, using a random-effects model. This study was registered in the University hospital Medical Information Network Clinical Trials Registry (Japan) as UMIN000049827. RESULTS The initial electronic search identified 611 records, of which 9 were included in this meta-analysis (177 735 pregnancies, 1242 with FMF, and 176 493 healthy controls). FMF was significantly associated with increased odds of preterm deliveries (OR, 1.67; 95% CI, 1.05-2.67; I2 = 22%) and insignificantly associated with increased odds of fetal growth restriction (OR, 1.45; 95% CI, 0.90-2.34; I2 = 0%) and hypertensive disorders during pregnancy (OR, 1.28; 95% CI, 0.87-1.87; I2 = 0%). CONCLUSION FMF was significantly associated with preterm delivery and insignificantly associated with fetal growth restriction and hypertensive disorders. All of the included studies were observational studies. Treatment characteristics were not fully collected from the articles, and further analysis of treatments for FMF in pregnancy is still warranted.
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Affiliation(s)
- Yuhya Hirahara
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Midori Yamaguchi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kaoru Takase-Minegishi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yohei Kirino
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Lisa Hirahara
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Michi Kasai
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Ayaka Maeda
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomi Tsuchida
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Nobuyuki Horita
- Chemotherapy Center, Yokohama City University Hospital, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Shindo R, Aoki S, Nakanishi S, Obata S, Miyagi E. Impact of Introducing a Controlled-Release Dinoprostone Vaginal Insert for Labor Induction: A Retrospective Single-Center Study in Japan. Cureus 2024; 16:e53180. [PMID: 38420080 PMCID: PMC10901581 DOI: 10.7759/cureus.53180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
AIM Cervical ripening is commonly performed before oxytocin administration during labor induction in pregnant women with an unfavorable cervix. In Japan, a controlled-release Dinoprostone vaginal insert (CR-DVI) was approved in 2020. Although many studies have compared the mechanical methods of ripening and prostaglandins, few have examined the impact of additional options for labor induction. This study aimed to assess the impact of CR-DVI as an additional option for labor induction in women with an unfavorable cervix. METHODS In this single-center retrospective study conducted in Japan, 265 participants were divided into two groups: before (January 2018 to May 2020) and after (June 2020 to November 2022) CR-DVI introduction. Before CR-DVI was introduced, hygroscopic dilators were used for all cases instead. On the other hand, after the introduction of CR-DVI, the first choice for cervical ripening was CR-DVI. The CR-DVI was retained vaginally for up to 12 hours after insertion. However, if hyper-stimulation or non-reassuring fetal status was suspected, or if a new membrane rupture occurred, it was removed immediately according to the removal criteria. Oxytocin infusions were used during both periods if needed. We compared delivery and neonatal outcomes between the groups. RESULTS The 265 participants were divided into two groups: before (n=116) and after (n=149) CR-DVI introduction. There were no significant differences in maternal characteristics except for the primiparous proportion. CR-DVI was used in 93% of cases after introduction. Hygroscopic dilators also continued to be used; however, their use decreased to about 34%. The vaginal delivery rate was significantly higher after the introduction of CR-DVI than before its introduction (50.9% vs. 66.4%; p=0.01). Multivariable analysis revealed a significantly higher rate of vaginal delivery after CR-DVI introduction. Of the 149 cases in which a CR-DVI was used, 111 (79.9%) were removed before 12 hours. There were no significant differences in neonatal outcomes. CONCLUSION The rate of vaginal delivery was higher after CR-DVI introduction than before its introduction, and adverse pregnancy outcomes did not increase. Therefore, introducing CR-DVI as an option for labor induction may increase the probability of vaginal delivery. Safety can also be ensured by adhering to the removal criteria.
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Affiliation(s)
- Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, JPN
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, JPN
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, JPN
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, JPN
| | - Etsuko Miyagi
- Obstetrics and Gynecology, Yokohama City University Medical Center, Yokohama, JPN
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Iijima T, Obata S, Miyagi E, Aoki S. Clinical Features of Preeclampsia Preceded by Fetal Growth Restriction. Cureus 2023; 15:e51275. [PMID: 38288232 PMCID: PMC10823203 DOI: 10.7759/cureus.51275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
AIM This study aimed to clarify the perinatal prognosis of preeclampsia (PE) with fetal growth restriction (FGR) and determine appropriate medical interventions for these conditions. METHODS Singleton births delivered to mothers diagnosed with PE with FGR and hypertension at a tertiary center between January 2010 and June 2021 were included. Only patients with PE were included in the analysis, and patients with superimposed PE were excluded. The FGR-preceding group (group F) included patients who developed FGR first and had elevated blood pressure. The remaining cases were defined as the hypertension-preceding group (group H). The perinatal outcomes between the two groups were then compared. The primary outcome was pregnancy prolongation defined as the time from PE diagnosis to delivery. Secondary outcomes included mode of delivery, maternal outcomes, and neonatal outcomes. RESULTS The mean gestational age at the time of PE diagnosis was 34.7 (26-40.1) weeks for group F and 30.3 (22.6-39.4) weeks for group H (P=0.004). The median pregnancy prolongation from the time of PE diagnosis to delivery was eight (2-30) days in group F and 10.5 (2-43) days in group H, with no significant difference (P=0.52). The incidence of maternal critical complications was 10.4% in group F and 28.1% in group H (P=0.03; odds ratio 3.36; 95% confidence interval 1.13-10). CONCLUSIONS Among patients with PE, group H was more likely to develop serious maternal complications than group F, suggesting different pathogenesis between these types of PE. Both groups required cautious perinatal management, but more stringent maternal management was required for group H.
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Affiliation(s)
- Takayoshi Iijima
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, JPN
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, JPN
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, JPN
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, JPN
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Umeda S, Abe T, Obata S, Aoki S, Takeuchi I. Effectiveness of call system implementation for postpartum hemorrhage in a tertiary emergency medical center: a retrospective cohort study. BMC Pregnancy Childbirth 2023; 23:787. [PMID: 37951860 PMCID: PMC10638699 DOI: 10.1186/s12884-023-06095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Postpartum hemorrhage is the leading cause of maternal death and severe maternal morbidity worldwide. Previous studies have reported the importance of multidisciplinary treatment approaches for postpartum hemorrhage; however, only a few studies have shown a clear improvement in maternal outcomes. Therefore, this study aimed to investigate the efficacy of a call system for postpartum hemorrhage in a tertiary emergency facility for rapid multidisciplinary treatment and its effect on maternal outcomes. METHODS This single-center retrospective cohort study included patients transferred to our hospital due to postpartum hemorrhage between April 1, 2013, and March 31, 2019. The primary outcome was mortality, and the secondary outcomes were morbidity (duration of hospital stay, duration of intensive care unit stay, admission to the intensive care unit, respirator use, duration of ventilator support, acute kidney injury, transfusion-associated circulatory overload/transfusion-related acute lung injury, hysterectomy, composite adverse events, blood transfusion initiation time, blood transfusion volume, and treatment for postpartum hemorrhage). An in-hospital call system implementation commenced on April 1, 2016. The study outcomes were compared 3 years before and after implementing the call system. RESULTS The blood transfusion initiation time and duration of hospital stay were significantly shortened after implementing the call system for postpartum hemorrhage. No maternal deaths were observed after implementing the system. CONCLUSIONS Implementing call systems specialized for postpartum hemorrhage in tertiary emergency facilities may improve maternal outcomes.
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Affiliation(s)
- Sayo Umeda
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.
| | - Takeru Abe
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
- Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Tsuchiya N, Obata S, Kasai M, Miyagi E, Aoki S. A case of cardiac arrest due to postpartum hemorrhage treated with hysterectomy and extracorporeal membrane oxygenation. Clin Case Rep 2023; 11:e7554. [PMID: 37323277 PMCID: PMC10264733 DOI: 10.1002/ccr3.7554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/14/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
Although extracorporeal membrane oxygenation is relatively contraindicated in patients with severe disseminated intravascular coagulation (DIC), it can be safely introduced by providing adequate anti-DIC therapy.
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Affiliation(s)
- Naoki Tsuchiya
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Michi Kasai
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University HospitalYokohamaJapan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
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Nakanishi S, Aoki S, Kasai J, Shindo R, Obata S, Hasegawa Y, Mochimaru A, Kurasawa K, Miyagi E. Non-efficacy of early intervention strategy for non-obese patients with early-onset gestational diabetes mellitus: solely based on the short-term outcomes. BMJ Open Diabetes Res Care 2023; 11:11/3/e003230. [PMID: 37270179 DOI: 10.1136/bmjdrc-2022-003230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/20/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION To verify the effectiveness of intervention in early pregnancy for women with early-onset gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS This study included women with a singleton pregnancy who were diagnosed with early-onset GDM by 20 weeks of gestation according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) threshold. We retrospectively evaluated the pregnancy outcomes in pregnant women with early-onset GDM. In the treatment from early pregnancy group (n=286), patients were diagnosed with early-onset GDM at the Yokohama City University Medical Center (YCU-MC) in 2015-2017 and were treated for GDM from early pregnancy. Concerning the treatment from mid-pregnancy group (n=248), participants were diagnosed with early-onset GDM at five sites, including the YCU-MC in 2018-2019, and were followed up without treatment until the second 75 g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Treatment for GDM was given only if the GDM pattern was still present in the second OGTT. RESULTS There were no significant differences in maternal backgrounds, including GDM risk factors and gestational weight gain, between the groups. Among the treatment from mid-pregnancy group, the false-positive early GDM was 124/248 (50%). Regarding pregnancy outcome, the rate of large for gestational age (LGA) was 8.8% in the treatment from early pregnancy group and 10% in the treatment from mid-pregnancy group, with no significant difference, whereas small for gestational age (SGA) was significantly higher in the treatment from early pregnancy group (9.4%) than in the treatment from mid-pregnancy group (4.8%) (p=0.046). There were no significant differences in maternal adverse events and neonatal outcomes between the groups. In a subanalysis limited to body mass index >25 kg/m2, LGA was significantly lower in the treatment from early pregnancy group than in the treatment from mid-pregnancy group. CONCLUSIONS The strategy for diagnosing GDM by IADPSG thresholds in early pregnancy and providing treatment to all patients from early pregnancy did not improve the pregnancy outcomes, but rather increased the SGA rate.
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Affiliation(s)
- Sayuri Nakanishi
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Junko Kasai
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
- Department of Obstetrics and Gynecology, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yoshimi Hasegawa
- Department of Obstetrics and Gynecology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, Japan
| | - Aya Mochimaru
- Department of Obstetrics and Gynecology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan
| | - Kentaro Kurasawa
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Obata S, Shindo R, Otani M, Miyagi E, Aoki S. Successful fertility preservation by expectant management of a cervico-isthmic pregnancy with fetal death in the second trimester: A case report. Case Rep Womens Health 2023; 38:e00501. [PMID: 37025400 PMCID: PMC10070074 DOI: 10.1016/j.crwh.2023.e00501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
In a cervico-isthmic pregnancy, the risk of placenta accreta increases with advancing gestational age. Previous reports have detailed cases that required hysterectomy at delivery or artificial abortion at an early gestational age. However, to the best of our knowledge, there have been no previous reports on the management of a cervico-isthmic pregnancy with fetal death during the second trimester. A 33-year-old primigravid woman was diagnosed with a cervico-isthmic pregnancy and fetal death at 15 weeks of gestation. Placenta accreta was suspected; hence, we chose expectant management and to observe the patient for placental tissue regression. After 5 weeks of expectant management, the ultrasonographic findings suggested remission of placenta accreta. Therefore, we performed a cesarean delivery and terminated the pregnancy. All uterine contents were removed, and the uterus was preserved. In cervico-isthmic pregnancy cases with fetal death, as in the current case, the possibility of fertility preservation could be increased by observing for placental tissue regression through expectant management.
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Kawasaki H, Masuda K, Isayama J, Aoto Y, Obata S, Fukushima-Nomura A, Ito Y, Tanase K, Kawakami E, Amagai M. 077 The thirteen bacterial species inversely correlated with disease activities of atopic dermatitis in human showed a biotherapeutic potential based on their suppressive effects in mice. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Iijima T, Obata S, Chuma M, Miyagi E, Aoki S. Rapid progression of hepatocellular carcinoma in a pregnant woman: A case report. Clin Case Rep 2022; 10:e6558. [PMID: 36381040 PMCID: PMC9638054 DOI: 10.1002/ccr3.6558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/07/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
Hepatocellular carcinoma (HCC) in pregnant women is rare; however, a recurrence of the disease is followed by rapid lesion progression during pregnancy. We experienced a case in which HCC recurred during pregnancy and rapidly worsened. After delivery at 33 weeks, she underwent chemotherapy and made a good progress.
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Affiliation(s)
- Takayoshi Iijima
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
| | - Makoto Chuma
- Department of Gastroenterology Yokohama City University Medical Center Yokohama Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
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Suzuki S, Sugo Y, Hiiragi K, Obata S, Iwata A, Imai Y, Aoki S, Kurasawa K, Miyagi E. Case of suspected lobular endocervical glandular hyperplasia in a cervical cystic lesion during pregnancy. Clin Case Rep 2022; 10:e6630. [PMCID: PMC9701866 DOI: 10.1002/ccr3.6630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/14/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sayaka Suzuki
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Yoshinobu Sugo
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Kazuya Hiiragi
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
| | - Akiko Iwata
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Yuichi Imai
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates Yokohama City University Medical Center Yokohama Japan
| | - Kentaro Kurasawa
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
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Utsunomiya M, Obata S, Suzuki S, Miyagi E, Aoki S. Clinical characteristics and pregnancy outcomes of cases with an incarcerated gravid uterus. J OBSTET GYNAECOL 2022; 42:2987-2991. [PMID: 36129465 DOI: 10.1080/01443615.2022.2124855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This study aimed to clarify the appropriate management of gravid uterus incarceration through a retrospective analysis of 10 women with an incarcerated gravid uterus who delivered at our hospital between 2000 and 2019. The incidence of an incarcerated gravid uterus was one in 2000 cases. Nine cases were diagnosed during pregnancy (15-30 gestational weeks) and one during caesarean section (performed at 37 gestational weeks on suspicion of placenta previa). Two women underwent manual reduction at 19 and 20 gestational weeks, respectively; the procedure failed in one case, and intrauterine foetal death occurred after the procedure. Among the remaining eight cases, spontaneous reduction was observed in three women at 31, 33 and 34 gestational weeks, respectively. The prevalence of incarcerated gravid uteri may be higher than that previously reported, cases may more likely recover spontaneously, and spontaneous reduction could occur in the third trimester.Impact StatementWhat is already known on this subject? Gravid uterine incarceration is a rare condition that occurs in one in 3000-10,000 cases. In addition, previous reports have suggested that manual reduction should not be attempted after the 20th week of gestation.What do the results of this study add? In the current study, the incidence of an incarcerated gravid uterus was one in 2000 cases, higher than that mentioned in previous reports. In addition, spontaneous reductions occurred in three of eight cases in which manual reductions were not performed at 31, 33 and 34 gestational weeks.What are the implications of these findings for clinical practice and/or further research? The prevalence of an incarcerated gravid uterus and the rate of spontaneous reduction might be higher than those reported in previous studies, and spontaneous reduction could occur in later gestational weeks than that previously reported. Further prospective multicentre studies are necessary to establish new evidence for the management of gravid uterine incarceration.
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Affiliation(s)
- Mariko Utsunomiya
- Perinatal Centre for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Centre for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Sayaka Suzuki
- Perinatal Centre for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Centre for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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13
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Ohkuchi A, Suzuki H, Matsubara K, Watanabe K, Saitou T, Oda H, Obata S, Kondo S, Noda K, Miyoshi J, Ikenoue S, Nomiyama M, Seki H, Sukegawa S, Ichigo S, Ando H, Fuseya C, Shimomura T, Suzuki R, Mimura K, Yasuhi I, Fukuda M, Hara S, Kurashina R, Shiozaki A, Matsubara S, Saito S. Exponential increase of the gestational-age-specific incidence of preeclampsia onset (COPE study): a multicenter retrospective cohort study in women with maternal check-ups at <20 weeks of gestation in Japan. Hypertens Res 2022; 45:1679-1689. [DOI: 10.1038/s41440-022-01013-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/08/2022] [Accepted: 08/13/2022] [Indexed: 11/09/2022]
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14
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Haruyama Y, Miyagi E, Kobashi G, Obata S, Umazume T, Yoshimi A, Hishimoto A, Kurasawa K, Suzuki Y, Ikeda T, Kimura T, Yamada H. Impact of health literacy on anxiety and depressive symptoms in pregnant women in Japan during the COVID-19 pandemic. Sci Rep 2022; 12:14042. [PMID: 35982222 PMCID: PMC9386675 DOI: 10.1038/s41598-022-18405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
To investigate the relationships between communicative and critical health literacy (CCHL) and anxiety and depressive symptoms (ADs) in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was conducted and 5466 pregnant women responded in Japan in September 2020. A Kessler 6 scale (K6) score ≥ 10, an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13, and four CCHL groups were analyzed using a logistic regression model and trend test. The proportions of pregnant women with a K6 score ≥ 10 and EPDS score ≥ 13 were 13.5 and 15.4%, respectively. In comparisons with the low CCHL group, the adjusted odds ratio (95% CI) for anxiety symptoms was 0.770 (0.604–0.982) in the high CCHL group, while those for depressive symptoms were 0.777 (0.639–0.946), 0.665 (0.537–0.824), and 0.666 (0.529–0.838) in the lower, higher, and high CCHL groups (all p < 0.05), respectively, after adjustments for potential confounding factors, such as age, weeks of gestation, complications, history, number of children, marital status, education, employment, and income. Higher CCHL was associated with significantly lower adjusted odds ratios for anxiety (p for trend = 0.019) and depressive symptoms (p for trend < 0.001). These results suggest a relationship between CCHL and ADs in pregnant women during the COVID-19 pandemic.
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Affiliation(s)
- Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Gen Kobashi
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.,Department of Public Health, Dokkyo Medical University, School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kentaro Kurasawa
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomoaki Ikeda
- Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
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15
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Nakanishi S, Aoki S, Shindo R, Obata S, Kasai J, Miyagi E. Do pregnancy outcomes of women with false-positive early gestational diabetes mellitus differ from those of women with normal glucose tolerance? BMC Endocr Disord 2022; 22:203. [PMID: 35964030 PMCID: PMC9375911 DOI: 10.1186/s12902-022-01124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND To investigate whether false-positive early gestational diabetes mellitus (GDM) women can be managed similarly as normal glucose tolerance (NGT) women. METHODS This retrospective study was conducted at a tertiary care center in Japan. Pregnancy and neonatal outcomes of 67 singleton pregnancies with false-positive early GDM and 1774 singleton pregnancies with NGT who delivered after 22 weeks of gestation were compared. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria (patients having one or more of the following: fasting plasma glucose ≥ 92 mg/dL and a 75 g oral glucose tolerance test (OGTT) value ≥ 180 mg/dL at 1 h, or ≥ 153 mg/dL at 2 h). Pregnant women diagnosed with GDM in early pregnancy who did not meet the diagnostic criteria on the second OGTT were defined as having false-positive early GDM. Women with false-positive early GDM did not receive any therapeutic intervention during gestation. RESULTS Maternal age, pre-pregnancy body mass index, and gestational weight gain were significantly higher in the false-positive GDM group than in the NGT group. No significant differences were found in pregnancy outcomes, including gestational age, birth weight, large for gestational age rate, and cesarean delivery rate. Except for a higher neonatal hypoglycemia rate in the false-positive early GDM group, no significant differences were found in neonatal outcomes. CONCLUSIONS There were no clinically significant differences between early GDM false-positive women exhibiting GDM patterns only during early pregnancy and NGT women. False-positive early GDM women can be managed similarly as NGT women, suggesting that World Health Organization diagnostic guidelines, applying the IADPSG criteria during early pregnancy, need revision.
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Affiliation(s)
- Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan.
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan
| | - Junko Kasai
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama City, Kanagawa, 232-0024, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama City, , Kanagawa, 236-0004, Japan
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16
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Hagiwara M, Nakanishi S, Shindo R, Obata S, Miyagi E, Aoki S. An extremely prolonged second stage of labor increases maternal complications but has no adverse effect on neonatal outcomes. J Obstet Gynaecol Res 2022; 48:1364-1369. [DOI: 10.1111/jog.15212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Mayumi Hagiwara
- Perinatal Center for Maternity and Neonate Yokohama City University Medical Center Yokohama Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonate Yokohama City University Medical Center Yokohama Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonate Yokohama City University Medical Center Yokohama Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonate Yokohama City University Medical Center Yokohama Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology Yokohama City University Hospital Yokohama Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate Yokohama City University Medical Center Yokohama Japan
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Hiiragi K, Obata S, Miyagi E, Aoki S. The current status, attitudes, and practices concerning maternal pertussis vaccination in obstetric delivery facilities in Kanagawa Prefecture, Japan: a questionnaire survey. Hum Vaccin Immunother 2021; 17:4235-4238. [PMID: 35016490 PMCID: PMC8828058 DOI: 10.1080/21645515.2021.1958609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
This study investigated the implementation status, attitudes, and practices regarding maternal pertussis vaccination in delivery facilities in Kanagawa, Japan. We conducted a questionnaire survey of pertussis vaccination during pregnancy at 125 delivery service facilities, excluding midwifery clinics, in Kanagawa Prefecture from June 18 to July 20, 2020. The questionnaire comprised multiple-choice items, with single or multiple answers depending on the question. Of the 125 facilities surveyed, valid responses were obtained from 72 facilities (58%). There were 41 primary clinics with birthing facilities (57%), 16 general hospitals (not designated perinatal centers) (22%), 10 regional perinatal centers (14%), and five tertiary perinatal centers (7%). None of the facilities administered pertussis vaccination during pregnancy. Forty facilities (56%) reported knowledge of the severity of neonatal and infant pertussis infections. Twenty-three facilities (32%) reported knowledge of the prevention of pertussis infection by vaccination during pregnancy. All facilities reported willingness to consider vaccination if included in the Japanese guidelines. In Japan, the pertussis vaccination during pregnancy is not highly practiced by obstetricians; thus, it is not as popular as in other countries. Further studies are needed to promote strategies to prevent pertussis infection in the neonatal and infant periods.
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Affiliation(s)
- Kazuya Hiiragi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan,CONTACT Soichiro Obata Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa232-0024, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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Hayama M, Maeda Y, Tsuda T, Akazawa H, Nakatani A, Obata S, Takeda K, Inohara H. Epistaxis limits the performed activities of daily living in proportion to its severity: a cross-sectional survey among patients with hereditary haemorrhagic telangiectasia. RHINOL 2021. [DOI: 10.4193/rhinol/21.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: We examined the severity of epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT) and its relationship with the performed activities of daily living. Methodology: This cross-sectional survey included 36 patients with HHT in Japan. An anonymous questionnaire survey was conducted regarding the severity of epistaxis, the measures adopted to prevent epistaxis, and the limitations in the performed activities of daily living. The latter was assessed using a visual analogue scale (VAS). The correlation between epistaxis severity and the VAS score was analysed using Spearman’s rank correlation coefficient. Results: Of the 36 participants surveyed, 94.4% had >1 episode of epistaxis/week. The mean epistaxis severity score (ESS) was 4.3 (range, 0.9–8.4). Limitations in daily life, going out (within a day), meeting with others, eating with others, and going on overnight trips were positively correlated with the ESS. To prevent nosebleeds, 44.4% and 41.7% of the participants used medications and avoided drying their nasal cavities, respectively. Conclusions: Epistaxis impacted the daily life of patients with HHT in proportion to its severity. Nonetheless, less than half of the patients used medications or took precautions. Hence, further educational activities should be considered for medical professionals and patients.
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Obata S, Shimura M, Misumi T, Nakanishi S, Shindo R, Miyagi E, Aoki S. Weight gain during twin pregnancy with favorable pregnancy outcomes in Japan: A retrospective investigation for new criteria based on perinatal registry data. PLoS One 2021; 16:e0253596. [PMID: 34214100 PMCID: PMC8253415 DOI: 10.1371/journal.pone.0253596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/08/2021] [Indexed: 12/17/2022] Open
Abstract
In 2009, the United States Institute of Medicine (IOM) reported the optimal gestational weight gain (GWG) during twin pregnancy based on the pre-pregnancy body mass index (BMI). However, there are ethnic variations in the relationship between GWG and pregnancy outcomes. We aimed to establish the criteria for optimal GWG during twin pregnancy in Japan. The study included cases of dichorionic diamniotic twin pregnancy registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System between 2013 and 2017. We analyzed data for cases wherein both babies were appropriate for gestational age and delivered at term. Cases were classified into four groups based on the pre-pregnancy BMI: underweight (BMI <18.5 kg/m2), normal weight (18.5 kg/m2 ≤BMI< 25.0 kg/m2), overweight (25.0 kg/m2 ≤BMI< 30.0 kg/m2), and obese (BMI ≥30.0 kg/m2) and we calculated the 25th-75th percentile range for GWG for the cases. The 3,936 cases were included. The GWG ranges were 11.5-16.5 kg, 10.3-16.0 kg, 6.9-14.7 kg, and 2.2-11.7 kg in the underweight, normal weight, overweight, and obese groups, respectively. Thus, in the current study, the optimal GWG during twin pregnancy was lower than that specified by the IOM criteria. Factoring this in maternal management may improve the outcomes of twin pregnancies in Japan.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
- * E-mail:
| | - Mai Shimura
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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20
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Obata S, Miyagi E, Haruyama Y, Umazume T, Kobashi G, Yoshimi A, Hishimoto A, Kurasawa K, Suzuki Y, Ikeda T, Kimura T, Yamada H. Psychological stress among pregnant and puerperal women in Japan during the coronavirus disease 2019 pandemic. J Obstet Gynaecol Res 2021; 47:2990-3000. [PMID: 34137109 PMCID: PMC8447435 DOI: 10.1111/jog.14877] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/27/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate psychological stress among pregnant and puerperal women in Japan during the coronavirus disease 2019 (COVID-19) pandemic. METHODS In this cross-sectional study, we recruited pregnant women and puerperal women who delivered between January and September 2020 in Japan, using an online questionnaire. Participants were divided into low, middle, and high groups according to the degree of the epidemic in their region of residence. Related factors were analyzed using the chi-squared test. The relationship between COVID-19 epidemic regions and depression risks and anxiety using the Edinburgh Postnatal Depression Scale (EPDS) and Kessler 6 scale (K6) was evaluated using a univariate and multivariable logistic regression model. RESULTS Overall, 7775 cases, including 4798 pregnant and 2977 puerperal women, were analyzed. The prevalence of high EPDS and K6 scores was significantly increased in pregnant women in the high than those in the low epidemic regions (EPDS: adjusted odds ratio [aOR] 1.453, 95% confidence interval [CI] 1.205-1.753; K6: aOR 1.601, 95% CI 1.338-1.918). There was no difference in EPDS score, but the prevalence of high K6 scores was significantly increased in puerperal women in the high than those in the low epidemic regions (aOR 1.342, 95% CI 1.066-1.690). Further, restriction on going to their hometown for delivery increased the prevalence of high EPDS scores among pregnant (aOR 1.663, 95% CI 1.296-2.133) and puerperal women (aOR 1.604, 95% CI 1.006-2.557). CONCLUSIONS Decreased support due to the COVID-19 pandemic affected the psychological status of pregnant and puerperal women; hence, investing medical resources in their healthcare essential.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kentaro Kurasawa
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomoaki Ikeda
- Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
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21
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Umazume T, Miyagi E, Haruyama Y, Obata S, Kobashi G, Kurasawa K, Suzuki Y, Ikeda T, Kimura T, Yamada H. The physical and mental burden on obstetricians and gynecologists during the COVID-19 pandemic: A September 2020 questionnaire study. J Obstet Gynaecol Res 2021; 47:3001-3007. [PMID: 34137114 PMCID: PMC8447212 DOI: 10.1111/jog.14878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
Aim The aim of this study was to clarify the physical and mental burden of the COIVD‐19 pandemic on obstetricians and gynecologists in Japan and to identify factors that increase the burden of their psychological stress. Methods A web‐based questionnaire was sent to obstetricians and gynecologists in Japan via email and social media to collect voluntary responses. This survey was conducted from September 1 to 30, 2020. Results A total of 852 valid responses were included in the analysis; 76% (644) of the physicians felt that the COVID‐19 pandemic caused them physical and mental stress equal to or greater than the most severe disaster they had ever experienced. Physicians who reported high mental and physical stress were more likely to be in areas with high numbers of infected patients (odds ratio (OR) 1.571, p = 0.012). Physicians experienced great stress to the point of wearing heavy personal protective equipment during routine vaginal deliveries by mothers with no COVID‐19 symptoms. This trend was markedly pronounced for physicians working in regions with fewer cases of COVID‐19 infection. Conclusions Obstetricians and gynecologists who reported high mental and physical stress were more likely to be in areas with high numbers of infected patients. One potential reason for this may be that they were required to wear more personal protective equipment than necessary. Infection control methods that ensure the safety of obstetricians and gynecologists while not causing unnecessary physical or psychological stress are needed.
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Affiliation(s)
- Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, School of Medicine, Tochigi, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, School of Medicine, Tochigi, Japan
| | - Kentaro Kurasawa
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomoaki Ikeda
- Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
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Obikane E, Baba T, Shinozaki T, Obata S, Nakanishi S, Murata C, Ushio E, Suzuki Y, Shirakawa N, Honda M, Sasaki N, Nishi D, O'Mahen H, Kawakami N. Internet-based behavioural activation to improve depressive symptoms and prevent child abuse in postnatal women (SmartMama): a protocol for a pragmatic randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:314. [PMID: 33879065 PMCID: PMC8057289 DOI: 10.1186/s12884-021-03767-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child abuse and postnatal depression are two public health problems that often co-occur, with rates of childhood maltreatment highest during the first year of life. Internet-based behavioural activation (iBA) therapy has demonstrated its efficacy for improving postnatal depression. No study has examined whether the iBA program is also effective at preventing child abuse. This study aims to investigate whether iBA improves depressive symptoms among mothers and prevents abusive behaviours towards children in postpartum mothers in a randomized controlled trial, stratifying on depressive mood status. The study also evaluates the implementation aspects of the program, including how users, medical providers, and managers perceive the program in terms of acceptability, appropriateness, feasibility, and harm done. METHODS The study is a non-blinded, stratified randomized controlled trial. Based on cut-off scores validated on Japanese mothers, participants will be stratified to either a low Edinburgh Postnatal Depression Scale (EPDS) group, (EPDS 0-8 points) or a high EPDS group (EPDS ≥9 points). A total of 390 postnatal women, 20 years or older, who have given birth within 10 weeks and have regular internet-access will be recruited at two hospitals. Participants will be randomly assigned to either treatment, with treatment as usual (TAU) or through intervention groups. The TAU group receives 12 weekly iBA sessions with online assignments and feedback from trained therapists. Co-primary outcomes are maternal depressive symptoms (EPDS) and psychological aggression toward children (Conflict Tactic Scale 1) at the 24-week follow-up survey. Secondary outcomes include maternal depressive symptoms, parental stress, bonding relationship, quality of life, maternal health care use, and paediatric outcomes such as physical development, preventive care attendance, and health care use. The study will also investigate the implementation outcomes of the program. DISCUSSION The study investigates the effectiveness of the iBA program for maternal depressive symptoms and psychological aggression toward children, as well as implementation outcomes, in a randomized-controlled trial. The iBA may be a potential strategy for improving maternal postnatal depression and preventing child abuse. TRIAL REGISTRATION The study protocol (issue date: 2019-Mar-01, original version 2019005NI-00) was registered at the UMIN Clinical Trial Registry (UMIN-CTR: ID UMIN 000036864 ).
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Affiliation(s)
- Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Baba
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Chie Murata
- Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Emiko Ushio
- Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yukio Suzuki
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Mari Honda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Uomoto M, Obata S, Yumoto A, Nakanishi S, Sasahara Y, Otani M, Miyagi E, Aoki S. A case of successful pregnancy in a septate uterus after discharge of decidual tissue in the second trimester. Clin Case Rep 2021; 9:2382-2384. [PMID: 33936699 PMCID: PMC8077306 DOI: 10.1002/ccr3.4042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/18/2022] Open
Abstract
In pregnant patients with a divided uterine cavity, the decidual tissue on the nonpregnant side may be discharged prior to the delivery of the fetus. The pregnancy can continue if the uterine contractions and vaginal bleeding are controlled and the fetus is not in distress.
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Affiliation(s)
- Mari Uomoto
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Ami Yumoto
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Sayuri Nakanishi
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Yukiko Sasahara
- Department of PathologyYokohama City University Medical CenterYokohamaJapan
| | - Masako Otani
- Department of PathologyYokohama City University Medical CenterYokohamaJapan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University HospitalYokohamaJapan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
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24
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Hiiragi K, Obata S, Misumi T, Miyagi E, Aoki S. Psychological stress associated with the COVID-19 pandemic in postpartum women in Yokohama, Japan. J Obstet Gynaecol Res 2021; 47:2126-2130. [PMID: 33759283 PMCID: PMC8251499 DOI: 10.1111/jog.14776] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/05/2021] [Accepted: 03/13/2021] [Indexed: 11/27/2022]
Abstract
Aim This study aimed to clarify how the COVID‐19 pandemic impacts psychological stress levels in postpartum women in Yokohama, Japan. Methods We retrospectively compared the rates of positive screening tests for postpartum depression (Edinburgh Postnatal Depression Scale score of 9 or more or self‐injury factors) and liaison/psychiatric intervention rates between pre‐pandemic and pandemic groups of postpartum women who delivered a live birth at our tertiary perinatal center in Yokohama, Japan between January 2019 and May 2020. Those whose postpartum health screening was performed in 2019 (March–June 2019) were considered the pre‐pandemic group, and those whose screening was performed between March and June 2020 were considered the pandemic group. Adjustments were made for maternal background, pregnancy, and delivery outcomes, including a history of psychiatric disorders, complications, preterm delivery, NICU admission, and maternal postpartum complications, and the data were analyzed using a logistic regression analysis. Results Postpartum health screenings were performed on 339 women before the pandemic and 279 women during the pandemic. Positive screening rates for postpartum depression did not change before and during the pandemic (adjusted odds ratio 1.48, 95% confidence interval 0.885–2.46). Conclusions There was no apparent increase in maternal psychological stress due to the COVID‐19 pandemic in Yokohama, Japan. Postpartum women responded differently in settings with varied levels of disease severity and social restrictions.
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Affiliation(s)
- Kazuya Hiiragi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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25
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Suzuki S, Obata S, Utsunomiya M, Miyagi E, Aoki S. A case of incarcerated gravid uterus with a history of cesarean section was a good candidate for manual reduction: A case report. Clin Case Rep 2021; 9:322-325. [PMID: 33489179 PMCID: PMC7813024 DOI: 10.1002/ccr3.3524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/24/2020] [Accepted: 09/19/2020] [Indexed: 11/23/2022] Open
Abstract
Because the anterior lower uterine segment is stretched, the incarcerated gravid uterus case with a history of cesarean section is a good candidate for manual reduction.
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Affiliation(s)
- Sayaka Suzuki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Mariko Utsunomiya
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University HospitalYokohamaJapan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
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26
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Shimura M, Obata S, Misumi T, Miyagi E, Aoki S. Are the Institute of Medicine guidelines for optimal gestational weight gain in twin pregnancies applicable to Japanese women? J Obstet Gynaecol Res 2020; 47:337-342. [PMID: 33051925 DOI: 10.1111/jog.14529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/17/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022]
Abstract
AIMS To investigate whether the Institute of Medicine (IOM) guidelines for optimal gestational weight gain (GWG) in twin pregnancies are applicable to Japanese women. METHODS This was a retrospective study involving women who delivered full-term twins at our tertiary center diagnosed with a normal prepregnancy body mass index. The women were divided into two groups, according to the optimal GWG recommended by the IOM (16.8-24.5 kg): the adequate GWG (AGWG) group with GWG meeting the guidelines and the low GWG (LGWG) group with GWG below the guidelines. Next, the women were divided into two groups according to birthweight: a group with both twins born appropriate for gestational age (AGA group) and a group with one or both twins born small for gestational age (SGA group). Their GWG as well as their pregnancy outcomes were compared. RESULTS A total of 265 women were included. The AGWG group had a significantly higher proportion of hypertensive disorders of pregnancy than the LGWG group. There was no significant difference in the proportion of women with both twins born AGA or the rate of admission to the neonatal intensive care unit. Meanwhile, the median GWG in the AGA group was 13.6 kg, which was significantly higher than 12.0 kg in the SGA group. And even the median GWG in the AGA group was below the lower limit of the IOM guidelines. CONCLUSION The optimal GWG for Japanese women with twin pregnancies may be below the IOM guidelines.
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Affiliation(s)
- Mai Shimura
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiro Misumi
- Department of Biostatistics, Yokohama City University school of Medicine, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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Akita K, Hayama M, Tsuda T, Maeda Y, Akazawa H, Nakatani A, Obata S, Takeda K, Inohara H. Factors impacting postoperative haemorrhage after transnasal endoscopic surgery. RHINOL 2020. [DOI: 10.4193/rhinol/20.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Nakanishi S, Aoki S, Kasai J, Shindo R, Obata S, Hasegawa Y, Mochimaru A, Miyagi E. High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy. BMJ Open Diabetes Res Care 2020; 8:8/1/e001234. [PMID: 32699112 PMCID: PMC7375392 DOI: 10.1136/bmjdrc-2020-001234] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION This study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy. RESEARCH DESIGN AND METHODS This multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24-28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention. RESULTS Of the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24-28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes. CONCLUSIONS Although women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.
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Affiliation(s)
- Sayuri Nakanishi
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Junko Kasai
- Department of Obstetrics and Gynecology, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yoshimi Hasegawa
- Department of Obstetrics and Gynecology, Saiseikai Yokohama-shi Nanbu Byoin, Yokohama, Kanagawa, Japan
| | - Aya Mochimaru
- Department of Obstetrics and Gynecology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
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Obata S, Tsuburai T, Shindo R, Aoki S, Miyagi E, Sakakibara H. Current situation and outcomes of pregnancy in women with Turner syndrome in Japan. J Obstet Gynaecol Res 2020; 46:1728-1734. [PMID: 32542901 DOI: 10.1111/jog.14352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 04/24/2020] [Accepted: 05/23/2020] [Indexed: 01/10/2023]
Abstract
AIM Reports on pregnancy and delivery in women with Turner syndrome (TS) in Japan are limited to case reports, and the current situation remains unclear. Therefore, this study aimed to clarify the current situation of pregnancy and delivery in women with TS in Japan. METHODS Our study comprised primary and secondary surveys and we included perinatal centers approved by the Ministry of Health, Labor and Welfare. RESULTS A total of 24 cases from 19 facilities were reported, and we obtained individual information for 20 cases from 16 facilities. Of these 20 patients, 13 (65%) had become pregnant via oocyte donation. Three of these patients had received oocyte donation in Japan, while the other 10 had received donations in foreign countries. The other seven patients became pregnant with their own oocyte, with spontaneous menarche. Live babies were delivered by 18 patients, while an induced abortion was required at 18 weeks of gestation in one patient and an intrauterine fetal death from an unknown cause was detected at 38 weeks of gestation in another patient. Cesarean section was performed in 14 patients, with the most frequent indication being cephalopelvic disproportion. The rate of implementation of screening for complications related to TS was low, suggesting insufficient cooperation between facilities responsible for TS treatment, infertility and pregnancy and delivery management. CONCLUSION To improve pregnancy outcomes in women with TS, improved cooperation between facilities and laws regarding oocyte donation in Japan are needed.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Taku Tsuburai
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Hideya Sakakibara
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
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30
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Obata S, Toda M, Tochio A, Hoshino A, Miyagi E, Aoki S. Fetal growth restriction as a diagnostic criterion for preeclampsia. Pregnancy Hypertens 2020; 21:58-62. [PMID: 32413588 DOI: 10.1016/j.preghy.2020.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/16/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Currently, no unified set of criteria to classify preeclampsia (PE) exists. Further, no consensus has been reached whether fetal growth restriction (FGR) should be included in diagnostic criteria for PE. We examined the adequacy of including FGR in diagnostic criteria for PE. STUDY DESIGN Singleton pregnancy patients who developed PE before 34 weeks of gestation managed at a tertiary center between 2010 and 2016 were included. Patients were divided into two groups according to cause for PE diagnosis. In addition, those diagnosed with PE because of gestational hypertension (GH) and FGR were divided into two groups according to presence of proteinuria or organ dysfunction during the expectant management. MAIN OUTCOME MEASURES Pregnancy prolongation from PE diagnosis. RESULTS Of 69 PE patients, 18 (28.1%) were diagnosed as PE with GH and only FGR (F group). Pregnancy prolongation between PE diagnosis to delivery was longer in the F group than in PE cases with primary organ dysfunction (P group) (21 vs 10 days, P = 0.049). Of 18 patients in the F group, 12 (66.7%) subsequently had proteinuria or organ dysfunction (S group). The remaining 6 patients (33.3%) had no subsequent proteinuria or organ dysfunction (N group). There were no significant differences in prolongation of pregnancy from organ dysfunction onset to delivery between the S and P groups (10 vs 10 days, P = 0.36). CONCLUSIONS Organ dysfunction onset may reflect PE progression more accurately than FGR onset. Further investigations on whether to include FGR into the diagnostic criteria for PE are needed.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
| | - Misaki Toda
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Azusa Tochio
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Asako Hoshino
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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31
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Cho T, Aoki S, Saigusa Y, Shindo R, Obata S, Kasai M, Enomoto K, Miyagi E. Risk Factors for Chlamydia trachomatis Infection and Preterm Birth in Pregnant Japanese Women: Does Chlamydial Infection Cause Preterm Birth? Jpn J Infect Dis 2020; 73:210-213. [PMID: 32009052 DOI: 10.7883/yoken.jjid.2019.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to clarify the risk factors for chlamydial infection and determine whether infection during pregnancy is associated with preterm birth in Japanese women. The subjects were women who underwent Chlamydia trachomatis polymerase chain reaction testing during a singleton pregnancy and delivered after the 22nd week of gestation at a tertiary care center between January 1, 2000 and December 31, 2016. We compared Chlamydia-positive (n = 259) and Chlamydianegative (n = 1,974) groups and evaluated the pregnancy outcomes. The Chlamydia-positive group had a higher rate of public assistance coverage, smoking during pregnancy, nulliparity, lack of a partner, presence of other sexually transmitted infections, high-risk social status, and younger age (P < 0.01). The incidence of preterm births was not different between the groups, with an odds ratio of 0.95 (95% confidence interval: 0.62-1.46). The incidences of low birth weight deliveries, premature rupture of membranes, and preterm premature rupture of membranes prior to the 37th week were also comparable between the groups. Chlamydial infection during pregnancy had no effect on preterm birth, even after adjustment for confounding factors.
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Affiliation(s)
- Tamaki Cho
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University Graduate School of Medicine
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Michi Kasai
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Kimiko Enomoto
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital
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Aoki M, Obata S, Odagami M, Miyagi E, Aoki S. Prenatal diagnosis of vasa previa and the course of the cord vessels contribute to the safety of cesarean sections: A case report. Clin Case Rep 2019; 7:2114-2117. [PMID: 31788261 PMCID: PMC6878040 DOI: 10.1002/ccr3.2432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 11/22/2022] Open
Abstract
Vasa previa can occur even in cases without placental malposition and the precise diagnosis of vasa previa, and the course of the cord vessels contributes to a safe delivery. The color Doppler is a useful and easy-to-use device to confirm the presence of vasa previa.
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Affiliation(s)
- Mihoko Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Mizuha Odagami
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University HospitalYokohamaJapan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
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Tochio A, Obata S, Saigusa Y, Shindo R, Miyagi E, Aoki S. Does pre‐eclampsia without proteinuria lead to different pregnancy outcomes than pre‐eclampsia with proteinuria? J Obstet Gynaecol Res 2019; 45:1576-1583. [DOI: 10.1111/jog.14017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Azusa Tochio
- Perinatal Center for Maternity and NeonatesYokohama City University Medical Center Yokohama Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical Center Yokohama Japan
| | - Yusuke Saigusa
- Department of Biostatistics and EpidemiologyYokohama City University Graduate School of Medicine and University Medical Center Yokohama Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and NeonatesYokohama City University Medical Center Yokohama Japan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University Hospital Yokohama Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical Center Yokohama Japan
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34
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Obata S, Tsuburai T, Shindo R, Aoki S, Miyagi E, Sakakibara H. Comprehensive medical treatment of women with Turner syndrome may improve pregnancy outcomes: A case report. Clin Pediatr Endocrinol 2019; 28:37-41. [PMID: 31037022 PMCID: PMC6476946 DOI: 10.1297/cpe.28.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/26/2018] [Indexed: 12/29/2022] Open
Abstract
A 35-year-old primiparous woman was diagnosed with Turner syndrome at the age of 12 yr
due to short stature. Her karyotype showed a mosaic pattern [45, X(19)/46, XX(11)]. She had been followed up by the pediatric
service. GH was not prescribed because, although she was of relatively short stature, her
growth trajectory was reasonable. She was started on estrogen replacement therapy at 15 yr
of age and switched to Kaufmann therapy after 1 yr. After transitioning her care to the
gynecology service at 20 yr of age, she was screened for complications and Kaufmann
therapy was continued. No abnormalities were detected in the pre-pregnancy screening. She
conceived by in vitro fertilization and embryo transplantation with
oocyte donation. No severe complications occurred during gestation, and she gave birth to
a female neonate vaginally at 41 wk and 6 d of gestation. The neonate’s birthweight was
3166 g, and her Apgar scores were 8 and 9 at 1 and 5 min, respectively. No severe
complications occurred during the postpartum period. Comprehensive medical treatment and
appropriate transition from pediatric to adult services may improve the pregnancy outcomes
of women with Turner syndrome.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Taku Tsuburai
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
| | - Ryosuke Shindo
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Hideya Sakakibara
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
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Obata S, Noguchi T, Chiba S, Miyagi E, Aoki S. Case of decidual discharge from the nonpregnant uterine cavity of the bicorporeal uterus before onset of delivery. J Obstet Gynaecol Res 2019; 45:1410-1413. [PMID: 30977221 DOI: 10.1111/jog.13971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/23/2019] [Indexed: 11/29/2022]
Abstract
A 30-year-old woman with a bicorporeal uterus complained of abdominal pain and vaginal hemorrhage at 28 weeks and 5 days of gestation. There were no signs of placenta previa with echography in the second trimester; however, the echography showed a highly echoic area (91 × 85 mm), indicating placenta previa. Thereafter, abdominal pain and vaginal bleeding increased. Thus, we suspected placental abruption and performed cesarean section. After cesarean section, discharge of placenta-like tissue into the vagina was confirmed and pathological examination of the tissue showed only the decidua. In cases of uterine malformations, in which the uterine cavity is divided into pregnant and nonpregnant sides, the decidua on the nonpregnant side can be discharged before the onset of delivery. In addition, at the time of decidual discharge, echography findings are similar to those of placenta previa and the clinical symptoms are similar to those of placental abruption.
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Affiliation(s)
- Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Noguchi
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Sawako Chiba
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
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Kino T, Obata S, Osanai N, Hashimoto A, Okada Y, Aoki S, Miyagi E. Labor may mask a symptom of the rupture of ovarian endometrial cyst: a case report. Clin Case Rep 2018; 6:1128-1131. [PMID: 29881581 PMCID: PMC5986002 DOI: 10.1002/ccr3.1554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/13/2018] [Accepted: 04/02/2018] [Indexed: 11/30/2022] Open
Abstract
As labor may mask a symptom of the rupture of ovarian cyst and delivery is a risk factor of its rupture, the possibility of rupture of ovarian cyst should always be considered during delivery.
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Affiliation(s)
- Tamina Kino
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Soichiro Obata
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Nana Osanai
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Ayasa Hashimoto
- GynecologyYokohama City University Medical CenterYokohamaJapan
| | - Yukiko Okada
- GynecologyYokohama City University Medical CenterYokohamaJapan
| | - Shigeru Aoki
- Perinatal Center for Maternity and NeonatesYokohama City University Medical CenterYokohamaJapan
| | - Etsuko Miyagi
- Department of Obstetrics and GynecologyYokohama City University HospitalYokohamaJapan
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Kawasaki H, Kawakami E, Obata S, Fukushima A, Yasuda-Sekiguchi F, Sasaki T, Suda W, Honda K, Ebihara T, Amagai M. 979 Quantitative skin microbiome analysis identified new microbial species associated with atopic dermatitis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Oawada N, Aoki S, Sakamaki K, Obata S, Seki K, Hirahara F. Clinical significance of low result of 1-h 50-g glucose-challenge test in pregnant women. J Matern Fetal Neonatal Med 2018; 32:58-61. [DOI: 10.1080/14767058.2017.1371130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nozomi Oawada
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Kentaro Sakamaki
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuo Seki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Fumiki Hirahara
- Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan
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Koreeda Y, Obata S, Nishio Y, Miura S, Kobayashi Y, Kawamura K, Souzaki R, Ieiri S, Hashizume M, Fujie MG. Development and testing of an endoscopic pseudo-viewpoint alternating system. Int J Comput Assist Radiol Surg 2014; 10:619-28. [PMID: 24950746 PMCID: PMC4411650 DOI: 10.1007/s11548-014-1083-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
Purpose An endoscopic system is needed that presents informative images irrespective of the surgical situation and the number of degrees of freedom in endoscopic manipulation. This goal may be achieved with a virtual reality view for a region of interest from an arbitrary viewpoint. An endoscopic pseudo-viewpoint alternation system for this purpose was developed and tested. Method Surgical experts and trainees from an endoscopic surgery training course at the minimally invasive surgery training center of Kyushu University were enrolled in a trial of a virtual reality system. The initial viewpoint was positioned to approximate the horizontal view often seen in laparoscopic surgery, with \documentclass[12pt]{minimal}
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\begin{document}$$20^{\circ }$$\end{document}20∘ between the optical axis of the endoscope and the task surface. A right-to-left suturing task with right hand, based on a task from the endoscopic surgery training course, was selected for testing. We compared task outcomes with and without use of a new virtual reality-viewing system. Result There was a 0.37 mm reduction in total error (\documentclass[12pt]{minimal}
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\begin{document}$$p = 0.02$$\end{document}p=0.02) with use of the proposed system. Error reduction was composed of 0.1 mm reduction on the y-axis and 0.27 mm reduction on the x-axis. Experts benefited more than novices from use of the proposed system. Most subjects worked at a pseudo-viewpoint of around 34\documentclass[12pt]{minimal}
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\begin{document}$$^\circ $$\end{document}∘. Discussion Suturing performance improved with the new virtual reality endoscopic display system. Viewpoint alternation resulted in an overview that improved depth perception and allowed subjects to better aim the marker. This suggests the proposed method offers users better visualization and control in endoscopic surgery.
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Affiliation(s)
- Y Koreeda
- Graduate School of Science and Engineering, Waseda University, 59-309, 3-4-1, Okubo, Shinjuku Ward, Tokyo, Japan,
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Obata S, Matsuo M, Ohta Y, Kan T, Kanegae S, Inoue Y, Kuroiwa A, Yamaguchi H. EP-1095: Salvage intensity-modulated radiation therapy for PSA failure after prostatectomy. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33401-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Obata S, Ohta Y, Kan T, Kanegae S, Inoue Y, Matsuo M, Hakariya T. EP-1091 SIMULTANOUS INTEGRATED BOOST USING INTENSITY MODULATED RADIATION THERAPY FOR HORMONE RESISTANT PROSTATE CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71424-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Obata S, Takatsuki H, Ohta Y, Kan T, Kanegae S, Inoue Y, Matsuo M. 1025 poster INTENSITY MODULATED RADIATION THERAPY FOR PROSTATE CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71147-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ozaki C, Obata S, Yamanaka H, Tominaga S, Suzuki ST. The extracellular domains of E- and N-cadherin determine the scattered punctate localization in epithelial cells and the cytoplasmic domains modulate the localization. J Biochem 2010. [DOI: 10.1093/jb/mvq046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Obata S, Goto H. Computational chemistry approach to polymorphism of aspirin. Acta Crystallogr A 2008. [DOI: 10.1107/s010876730809288x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Nakayama N, Obata S, Ohta K, Goto H. Development of polarizable force field for the prediction of molecular crystal structures. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308093355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Masuyama S, Komiya T, Tamura N, Sakaguchi G, Obata S, Kimura C, Kobayashi T, Nakamura H. [Coronary malperfusion of left main trunk due to localized dissection of the ascending aorta]. Kyobu Geka 2007; 60:433-7; discussion 437-40. [PMID: 17564056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Case 1. Forty nine years woman was given a diagnosis of acute myocardial infarction. Coronary angiography and trans-esophageal echocardiography showed left main trunk dissection due to local aortic root dissection. We operated surgical repair at left main trunk by pericardium after percutaneous coronary intervention. Case 2. Forty nine years man was given a diagnosis of acute myocardial infarction caused by left main trunk dissection due to traumatic local aortic root dissection. We operated coronary artery bypass grafting after insertion of perfusion catheter to left main trunk for maintain coronary perfusion. Although local dissection of aortic aorta is relatively rare, it is potentially complicated with coronary malperfusion. We describe 2 success a cases of surgical treatment for local acute type A aortic dissection complicated with coronary malperfusion.
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Affiliation(s)
- Shinji Masuyama
- Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan
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Matsuo S, Yamaguchi S, Miyamoto S, Ishii T, Tsuneoka N, Obata S, Hayashi T, Kanematsu T. Ruptured aneurysm of the visceral artery: report of two cases. Surg Today 2002; 31:660-4. [PMID: 11495164 DOI: 10.1007/s005950170103] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present herein two cases of a ruptured aneurysm of the visceral artery. The first case involved a 74-year-old man with abdominal pain who was admitted to our hospital with a tentative diagnosis of intra-abdominal bleeding of unknown origin. Computed tomography revealed a hematoma in the greater curvature of the stomach. At surgery, a hematoma along the right gastroepiploic artery was found and totally removed. Histological examination showed a pseudo-aneurysm of unknown etiology. The second case involved a 68-year-old man with progressive anemia who presented with spontaneous intra-abdominal bleeding. A ruptured aneurysm of the accessory middle colic artery was diagnosed by superior mesenteric angiography. The ruptured aneurysm was ligated and totally resected without a colectomy. Histological examination showed a pseudoaneurysm of unknown etiology. The postoperative courses were uneventful, and both patients were doing well at the time of writing.
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Affiliation(s)
- S Matsuo
- Department of Surgery, Nagasaki Prefectural Shimabara Onsen Hospital, Japan
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Obata S, Hirata Y, Sunakawa K, Inoue M. [An epidemiological study for fungus isolation during the twenty-five year periods from 1976 to 2000 in Kitasato University Hospital]. Kansenshogaku Zasshi 2001; 75:863-9. [PMID: 11712361 DOI: 10.11150/kansenshogakuzasshi1970.75.863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We investigated an epidemiological study for fungus isolation in our hospital from 1976 to 2000. For 25 years, the total sample number of fungus examination were 64,296, and after 1988, the total sample number increased suddenly. As a whole, the positive ratio was constantly about 40%. When our hospital opened, the obstetrical and gynecological samples showed 38.8% for fungus examination, but recently, samples of the respiratory organ has increased. Ratio of isolation for yeast, Candida albicans was 53.8%, and another yeasts such as Candida glabrata, Candida tropicalis, Candida parapsilosis were 12.5%, 5.3%, and 3.4%, respectively. Recently, isolation of Candida glabrata showed a tendency to increase. For genus Aspergillus, Aspergillus fumigatus was isolated, 48.1%, and Aspergillus nigar, Aspergillus terreus were isolated, 31.4% and 7.5%, respectively. For dermatophytes, Trichophyton rubrum was isolated, 63.6% indermatophytes, and another dermatophytes were Microsporum canis (17.9%), and Trichophyton mentagrophytes (15.9%), respectively. For dermatophytes, isolation of Microsporum canis showed a tendency to increase. Recently, the plural number of species showed a tendency to increase in the samples. Compared with the number of samples at the beginning in our hospital, the plural number of species in the samples increased about six times.
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Affiliation(s)
- S Obata
- Department of Clinical Laboratory, Kitasato University Hospital
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Suzuki A, Obata S, Hayashida M, Kawano H, Nakano T, Shiraki K. Retraction: SADS: A new component of Fas-DISC is the accelerator for cell death signaling and is downregulated in patients with colon carcinoma. Nat Med 2001; 7:749. [PMID: 11385516 DOI: 10.1038/89136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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