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Faculty of Medicine School of Medicine Department of Developmental and Urological-Reproductive Medicine, Obstetrics and Gynecology |
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Related SDGs |
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KATSURAGI Shinji
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Papers 【 display / non-display 】
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Maternal Death Due to Pulmonary Arterial Hypertension ― A Nationwide Survey in Japan ―
Aoki-Kamiya Chizuko, Katsuragi Shinji, Shiina Yumi, Hasegawa Junichi, Yoshimatsu Jun, Nakai Akihito, Ishiwata Isamu, Sekizawa Akihiko, Ikeda Tomoaki, on behalf of the Japanese Maternal Death Exploratory Committee and the Japan Association of Obstetricians and Gynecologists
Circulation Journal 89 ( 1 ) 77 - 82 2024.12
Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Circulation Society
<b><i>Background:</i></b> With advances in treatment, the prognosis for pregnancies complicated by pulmonary arterial hypertension (PAH) has been improving. However, PAH-related maternal mortality remains high compared with that due to other cardiovascular diseases. The specifics of PAH-related maternal deaths under advanced medical standards are not well understood.<b><i>Methods and Results:</i></b> We used the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and reviewed 6 PAH-related maternal deaths from 2010 to 2022. All women were initially diagnosed with PAH during pregnancy or immediately after childbirth. The diagnosis of PAH tended to be delayed because symptoms were not reported to healthcare providers and/or a different disease was diagnosed. Cardiogenic shock occurred antepartum in 1 woman and during delivery or within 7 days after delivery in the other 5 women. Four women were resuscitated and started on extracorporeal membrane oxygenation. Pulmonary vasodilators were initiated in 4 women, with a median duration of 8 days from PAH diagnosis to starting medication. Right heart failure was the most common cause of maternal death, with a median duration of 16 days from PAH diagnosis to maternal death.<b><i>Conclusions:</i></b> All PAH-related maternal deaths occurred in women who were diagnosed with PAH after pregnancy. Diagnosing PAH and initiating pulmonary vasodilators takes considerable time, highlighting the importance of early diagnosis and early treatment.
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Out-of-pocket fertility preservation expenses: data from a Japanese nationwide multicenter survey
Ono M., Takai Y., Harada M., Horie A., Dai Y., Kikuchi E., Miyachi M., Yamamoto T., Fujii N., Kajiyama H., Manabe A., Yasuoka T., Katsuragi S., Mekaru K., Maezawa T., Horage Y., Kataoka S., Nakayama R., Nakajima T.E., Kimura F., Shimizu C., Sugimoto K., Takae S., Yumura Y., Nishi H., Furui T., Morishige K.I., Watanabe C., Osuga Y., Suzuki N.
International Journal of Clinical Oncology 29 ( 12 ) 1959 - 1966 2024.12
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Clinical Oncology
Background: The expenses related to fertility preservation or subsequent assisted reproductive treatments are significant for adolescents and young adult patients in Japan’s current healthcare system. With fertility preservation becoming more widespread in developed countries, it is expected that these costs will be covered by insurance or subsidies. It is critical for patients, healthcare providers, and the government to know the costs that patients will be responsible for. In Japan, the costs of fertility preservation and subsequent assisted reproductive technology are not covered by insurance, but patients can apply for subsidies from the local and central governments if certain conditions are met. Presently, the above-mentioned costs, as well as the amount paid by the patient, vary by facility. Therefore, it is essential to ensure patients’ continued access to necessary medical care despite the associated costs. Methods: In this study, questionnaires were mailed to 186 certified fertility preservation facilities in Japan to assess patients who had undergone fertility preservation or assisted reproduction. The questionnaires were sent between October 27, 2023 and March 31, 2024, with 140 of the 186 facilities responding (response rate: 75.3%). Results: Our findings show that approximately one-third of the costs was borne by the patients. Conclusion: Given these circumstances, sustainable pricing and insurance coverage are necessary for both patients and facilities.
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Tachycardia-Induced Cardiomyopathy Following Prolonged Ritodrine Infusion During Pregnancy: A Case Report.
Nakao M, Izawa M, Takamisawa I, Horiuchi C, Ohmori A, Katsuragi S
Cureus 16 ( 12 ) e76465 2024.12
Language：English Publishing type：Research paper (scientific journal)
DOI： 10.7759/cureus.76465
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Hasegawa J., Sekizawa A., Tanaka H., Katsuragi S., Tanaka K., Nakata M., Hayata E., Murakoshi T., Ishiwata I., Ikeda T.
International Journal of Infectious Diseases 146 2024.9
Publishing type：Research paper (scientific journal) Publisher：International Journal of Infectious Diseases
Objectives: To clarify the infection route in maternal death due to invasive group A streptococcal (GAS) infection and toxic shock syndrome (TSS). Methods: A retrospective study was conducted on maternal deaths due to GAS-TSS in Japan between January 2010 and March 2024. The final causal diagnosis of maternal death and the infection routes of GAS were analysed using medical records, laboratory data and autopsy findings. Results: Among the 616 maternal deaths during the study period, 48 (8%) involved infectious diseases. The most common infection was invasive GAS (56%, n = 27), 21 (78%) and six cases occurred during the antepartum and puerperium periods, respectively. In the GAS-TSS group, 71% (15/21) infections were originated the upper respiratory tract. However, in the puerperium cases, 67% (4/6) were infected from the genital tract. In addition, no maternal deaths due to GAS-TSS were reported during the COVID-19 pandemic period in Japan from 2020 to 2023. Conclusion: Most antepartum GAS infections were from the upper respiratory tract. They may be reduced by preventive measures, including frequent disinfection, wearing masks and isolation from persons at high risk of carrying GAS, such as symptomatic children. On the other hand, GAS-TSS during puerperium infection via the genital tract.
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Relationship between maternal mortality and ritodrine hydrochloride as a tocolytic agent in Japan
Nakamura M., Sekizawa A., Hasegawa J., Nakata M., Katsuragi S., Tanaka H., Murakoshi T., Kanayama N., Ishiwata I., Ikeda T.
The journal of obstetrics and gynaecology research 50 ( 7 ) 1111 - 1117 2024.7
Publishing type：Research paper (scientific journal) Publisher：The journal of obstetrics and gynaecology research
AIM: In Japan, unlike Western countries, tocolytic agents are administered in long-term protocols to treat threatened preterm labor. Evaluating the side effects of this practice is crucial. We examined whether ritodrine hydrochloride had been administered in cases of maternal death, aiming to investigate any relationship between ritodrine administration and maternal death. METHODS: This retrospective cohort study used reports of maternal deaths from multiple institutions in Japan between 2010 and 2020. Data on the reported cases were retrospectively analyzed, and data on the route of administration, administered dose, and clinical findings, including causes of maternal death, were extracted. The amount of tocolytic agents was compared between maternal deaths with ritodrine administration and those without. RESULTS: A total of 390 maternal deaths were reported to the Maternal Death Exploratory Committee in Japan during the study period. Ritodrine hydrochloride was administered in 32 of these cases. The frequencies (n) and median doses (range) of oral or intravenous ritodrine hydrochloride were 34.4% (11) and 945 (5-2100) mg and 84.4% (27) and 4032 (50-18 680) mg, respectively. Frequencies of perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema as causes of maternal death were significantly higher with ritodrine administration than without it. CONCLUSIONS: Our results suggest a relationship between long-term administration of ritodrine hydrochloride and an increased risk of maternal death due to perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema. In cases where ritodrine should be administered to prevent preterm labor, careful management and monitoring of maternal symptoms are required.
DOI： 10.1111/jog.15951
Books 【 display / non-display 】
MISC 【 display / non-display 】
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Enomoto N., Tanaka H., Maki S., Takakura S., Tanaka K., Katsuragi S., Ikeda T.
Taiwanese Journal of Obstetrics and Gynecology 62 ( 6 ) 2023.11
Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：Taiwanese Journal of Obstetrics and Gynecology
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/policies/article-withdrawal). This article has been retracted at the request of the Editors. As the result of the submission of a correspondence article discussing concerns with the current study [1], the journal was made aware of allegations that some of the data presented in this article appeared to be identical to data presented in a previous publication by some of the same authors as in the present work [2]. Upon further investigation and assessment of the article, the journal found multiple instances of data in the current article that indeed appear to be duplicated. Specifically, Table 1 (Clinical parameters of the participants), Table 2 (Estimated tadalafil pharmacokinetic parameters in pregnant and non-pregnant women), and Figure 1 (Average concentration–time profiles of tadalafil and unbound tadalafil in pregnant and non-pregnant women) appear to have been reproduced from the previous publication without appropriate citation [2]. Additionally, reexamination of the article by the Editors has led them to conclude firstly that the side effects evaluated by the authors were overly subjective, and secondly that the authors failed to show the outcomes of fetuses in their study, but nonetheless claimed safety in the use of tadalafil in pregnant women, with both points raising questions about the reliability of the study's conclusions. The authors were contacted for comment but did not provide an explanation for the concerns listed above. The degree of redundant publication detailed above represents a misuse of the scientific publishing system. This, in addition to concerns regarding the reliability of the article's conclusions, has led to the decision to retract the article. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
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妊娠高血圧症候群に関連した死亡の削減に向けて
桂木真司
周産期医学 2023.3
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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もやもや病・脳動静脈奇形
桂木真司
ペリネイタルケア 2023.1
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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妊娠中の巨大子宮筋腫合併-核出術を行わない
桂木真司
周産期医学 2022.12
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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多胎妊娠の基礎知識 娩出時期と分娩管理
桂木真司
周産期医学 2022.9
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
Presentations 【 display / non-display 】
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妊娠初期の高血圧管理 妊産婦とメンタルヘルス
桂木真司
令和5年度宮崎県産婦人科病医院従事者研修会 第27回ひむかセミナー
Event date： 2024.3.2 - 2024.3.3
Presentation type：Oral presentation (invited, special)
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HELLP症候群と非典型溶結性尿毒症症候群
桂木真司
宮崎aHUSセミナー
Event date： 2024.2.29
Presentation type：Oral presentation (invited, special)
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肺動脈性肺高血圧症と妊娠・出産
桂木真司
74ｔｈ ACHD NIGHT
Event date： 2024.2.16
Presentation type：Oral presentation (invited, special)
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内科の先生に伝えたい妊産婦の管理
桂木真司
都城市北諸県郡医師会内科医会学術講演会
Event date： 2024.2.13
Presentation type：Oral presentation (invited, special)
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妊娠高血圧症候群による脳卒中の予防とアスピリン療法による次回妊娠の予防効果
桂木真司
日本周産期・新生児医学会第42回周産期学シンポジウム
Event date： 2024.1.26 - 2024.1.27
Presentation type：Oral presentation (invited, special)
Grant-in-Aid for Scientific Research 【 display / non-display 】
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胎児期の低栄養環境による行動異常の発症とその早期診断に有効なマーカーに関する研究
Grant number：24K14793 2024.04 - 2027.03
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
Authorship：Principal investigator
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小児・AYA 世代のがん患者等に対する妊孕性温存療法のエビデンス 確立を目指した研究―安全性と有効性の創出を目指して
Grant number：24EA2001 2024.04 - 2026.03
厚生労働省 厚生科研 がん対策推進総合研究事業
Authorship：Coinvestigator(s)
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インド地下水汚染地域における妊娠、出産および小児の発育・発達に関する研究
Grant number：20KK0222 2020.10 - 2025.03
独立行政法人日本学術振興会 科学研究費基金 国際共同研究加速基金(国際共同研究強化(B))
Authorship：Coinvestigator(s)
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安心・安全な分娩を支援するtailor-made型の子宮頸管開大予測モデルの開発
Grant number：20K10831 2020.04 - 2024.03
独立行政法人日本学術振興会 科学研究費補助金 基盤研究(C)
Authorship：Coinvestigator(s)
Available Technology 【 display / non-display 】
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ロボット支援下手術の手術手技の開発
がん・生殖医療におけるネットワーク構築
動物実験：子宮内胎児発育遅延モデルMessage：産婦人科では胎児期の環境が成人病の発症に寄与するDoHAD仮説の疫学検証、動物実験モデルを用いた研究を行っています。2021年からがん・生殖医療分野では妊孕性温存療法の患者支援を行っています。産婦人科領域の診療、研究を発展させ、産官学連携を積極的に推し進めて参ります。