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医学部 医学科 発達泌尿生殖医学講座産婦人科学分野 |
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Doi K., Kodama Y., Matsuzawa S., Goto T., Muraoka J., Fujisaki M., Yamada N., Taniguchi H., Furuta K., Kawagoe Y., Kaneko M., Katsuragi S., Ikenoue T., Sameshima H.
Early Human Development 216 106495 2026年5月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Early Human Development
Objective: The ultimate goal of perinatal care is to ensure that infants survive without neurological impairment. Despite advances in medical technology and healthcare systems that have markedly decreased perinatal mortality, cerebral palsy has shown only a gradual decline in recent population-based studies. The aim of this study was to use a pathway classification system to analyze brain injury cases detected at or beyond 35 weeks' gestation and to clarify temporal changes in the incidence and causal pathways of intrapartum brain injury and its contributing factors in Miyazaki Prefecture, Japan. Methods: Of 151,558 births recorded in Miyazaki Prefecture from 2001 to 2015, 303 cases of brain injury were registered in the regional perinatal case-review system. Of these, 134 were detected at ≥35 weeks. Brain injury was categorized as congenital anomalies, antepartum, intrapartum, or neonatal onset. Each case was further classified using a pathway system that considered distal and proximal risk factors. Temporal trend analysis was performed across three consecutive 5-year intervals (2001–2005, 2006–2010, and 2011–2015). Results: Of the 134 cases, 25% were classified as intrapartum-related, 23% as antepartum-related, and 5% as neonatal-related. Overall, the incidence of brain injury at ≥35 weeks decreased significantly over time. Significant downward trends were observed in total cases and intrapartum-related brain injury, with the reduction in intrapartum cases being especially pronounced. Antepartum-related brain injury declined more gradually. Further analysis revealed that the incidence of hypoxia-related intrapartum brain injuries decreased over time, whereas bacterial infection-related intrapartum cases were observed only in the earliest epoch. Conclusions: This population-based study identified temporal changes in perinatal brain injury detected at or beyond 35 weeks' gestation over 15 years. The incidence of perinatal brain injury declined significantly, particularly intrapartum-related cases with hypoxia-related injury. These improvements might reflect advances in regionalized perinatal care, the establishment of perinatal centers, or multidisciplinary education and training. Further efforts to optimize intrapartum assessment and management would contribute to continued reductions in severe perinatal brain injury.
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村岡 純輔, 土井 宏太郎, 當瀬 ちひろ, 吉本 望, 松澤 聡史, 桂木 真司
Case Reports in Obstetrics and Gynecology 2026 4556829 2026年3月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Wiley
A 44-year-old Japanese woman with no history of uterine surgery or trauma was admitted for pregnancy termination at 20 weeks due to a fetal abnormality. A vaginal gemeprost pessary was administered into the posterior fornix under prescribed doses. During the second day of treatment, she developed hemorrhagic shock from a uterine rupture (UR) in the lower myometrial segment, with the uterovesical serosa remaining intact. She required massive transfusion therapy and a hysterectomy and was initially recovering. However, 3 days postoperation, she exhibited significant abdominal bleeding due to rupture of a uterine artery pseudoaneurysm (UAP), which required hemostatic surgery. This novel case highlights the risk of UR during second-trimester medical abortion (STMA) with gemeprost, even in unscarred uteri. Detection of cervical displacement via vaginal examination may lead to the diagnosis of UR. Laparotomy should be performed following cardiovascular collapse, even if an ultrasonography could not reveal intraperitoneal bleeding. Additionally, the varied anatomical damage to the uterus can result in complicating the conventional surgical approach and contributing to the formation of a pseudoaneurysm. Such extraordinary cases are best managed by experienced clinicians and skilled surgical teams.
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Muraoka J., Doi K., Tose C., Yoshimoto N., Matsuzawa S., Katsuragi S.
Case Reports in Obstetrics and Gynecology 2026 ( 1 ) 2026年
掲載種別：研究論文（学術雑誌） 出版者・発行元：Case Reports in Obstetrics and Gynecology
A 44-year-old Japanese woman with no history of uterine surgery or trauma was admitted for pregnancy termination at 20 weeks due to a fetal abnormality. A vaginal gemeprost pessary was administered into the posterior fornix under prescribed doses. During the second day of treatment, she developed hemorrhagic shock from a uterine rupture (UR) in the lower myometrial segment, with the uterovesical serosa remaining intact. She required massive transfusion therapy and a hysterectomy and was initially recovering. However, 3 days postoperation, she exhibited significant abdominal bleeding due to rupture of a uterine artery pseudoaneurysm (UAP), which required hemostatic surgery. This novel case highlights the risk of UR during second-trimester medical abortion (STMA) with gemeprost, even in unscarred uteri. Detection of cervical displacement via vaginal examination may lead to the diagnosis of UR. Laparotomy should be performed following cardiovascular collapse, even if an ultrasonography could not reveal intraperitoneal bleeding. Additionally, the varied anatomical damage to the uterus can result in complicating the conventional surgical approach and contributing to the formation of a pseudoaneurysm. Such extraordinary cases are best managed by experienced clinicians and skilled surgical teams.
DOI： 10.1155/crog/4556829
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骨髄異型性症候群合併妊娠の管理 査読あり
松澤聡史
宮崎県医師会医学会誌 48 ( 1 ) 113 - 116 2024年3月
掲載種別：症例報告
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Yamada N., Kaneko M., Yang L., Matsuzawa S., Minematsu T., Kodama Y.
Journal of Infection and Chemotherapy 29 ( 11 ) 1071 - 1074 2023年11月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Infection and Chemotherapy
Human cytomegalovirus (HCMV) is the major cause of neurological sequelae in infants. Immune control of primary HCMV infection appears to depend on the interaction between humoral and cell-mediated immune responses. We report the case of an HCMV-transmitter mother observed with dissociation between humoral and cell-mediated immune responses. The patient had immunoglobulin (Ig) G and M positivity at 11 weeks of gestation and showed fetal hyperechoic bowel and minimal ascites at 21 weeks of gestation. At 25 weeks of gestation, the polymerase chain reaction result for HCMV using amniotic fluid was positive. The numbers of spots in the enzyme-linked immunosorbent spot (ELISPOT) assay at 25, 36, and 39 weeks of gestation were three, five, and six spots/2 × 10<sup>5</sup> peripheral blood mononuclear cells, respectively. Furthermore, IgG avidity indexes (AIs) at 21, 25, 36, and 39 weeks of gestation were 37.6, 49.7, 72.5, and 74.3, respectively. At 40<sup>+1</sup> weeks of gestation, the patient delivered a symptomatic infected newborn with a weight of 2,384 g (−2.6 SD) and a head circumference of 30 cm (−2.6 SD). The neonate had a petechial rash and bilateral hearing loss although did not show liver dysfunction or thrombocytopenia. Cranial magnetic resonance imaging revealed mild ventriculomegaly, left lateral/parietal polymicrogyria, and a punctate white matter lesion. This case showed that IgG AI increased with increasing gestational age, whereas the numbers of spots in the ELISPOT assay had no change. The dissociation between humoral and cell-mediated immune responses may be characteristic of the immune response of a transmitter mother.
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【分娩時】子宮収縮の評価
松澤聡史
ペリネイタルケア 2022年9月
掲載種別：記事・総説・解説・論説等（学術雑誌）
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外来で胎児が徐脈になっている
松澤聡史
周産期医学 2022年8月
掲載種別：記事・総説・解説・論説等（学術雑誌）
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母体の背景と管理法 切迫早産の管理
松澤聡史
周産期医学 51 ( 8 ) 1109 - 1102 2021年8月
担当区分：筆頭著者 記述言語：日本語 掲載種別：記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
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産婦人科感染症 招待あり
松澤聡史、古川誠志、鮫島浩
臨床と研究 95 ( 5 ) 523 - 527 2018年5月
記述言語：日本語 掲載種別：記事・総説・解説・論説等（学術雑誌）
講演・口頭発表等 【 表示 ／ 非表示 】
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妊娠糖尿病の診断時期に関する検討
松澤聡史
第39回日本糖尿病・妊娠学会年次学術集会
開催年月日： 2023年11月17日 - 2023年11月18日
会議種別：口頭発表（一般）
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当院における胎児鏡下胎盤吻合血管レーザー凝固術後の一絨毛膜二羊膜双胎の短期予後の検討
松澤聡史
第79回九州新生児研究会
開催年月日： 2023年11月11日
会議種別：口頭発表（一般）
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前置癒着胎盤における大動脈遮断バルーンカテーテルの使用経験
松澤聡史
第31回日本胎盤学会学術集会・第41回日本絨毛性疾患研究会
開催年月日： 2023年11月3日 - 2023年11月4日
会議種別：ポスター発表
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厚切り凍結切片一低真空走査型電子顕微鏡解析法によるヒト胎盤絨毛組織の高精細三次元立体構造解析
松澤聡史
第31回日本胎盤学会学術集会・第41回日本絨毛性疾患研究会
開催年月日： 2023年11月3日 - 2023年11月4日
会議種別：ポスター発表
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当院で対応した無介助分娩希望の2症例
松澤聡史
令和5年度宮崎県母性衛生学会総会・学術集会
開催年月日： 2023年10月28日
会議種別：口頭発表（一般）