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Faculty of Medicine School of Medicine Department of Developmental and Urological-Reproductive Medicine, Obstetrics and Gynecology |
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DOI Koutarou
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Degree 【 display / non-display 】
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MD.Ph.D ( 2013.3 University of Miyazaki )
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学士（医学） ( 2000.3 鹿児島大学 )
Papers 【 display / non-display 】
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Doi K., Yamaguchi M., Iwai M., Terakawa C., Makino S., Maruyama R., Kusumoto K., Sato K., Tomimori K., Goto Y., Goto T., Matsuzawa S., Fujisaki M., Kodama Y., Katsuragi S.
Journal of Genetic Counseling 35 ( 5 ) e70286 2026.10
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Genetic Counseling
This study evaluated the association between first-trimester ultrasound abnormalities and prenatal test selection within a centralized genetic counseling system in Japan. Advances in ultrasound screening and the increasing use of non-invasive prenatal testing (NIPT) have expanded prenatal testing options, increasing the complexity of test selection in pregnancies with abnormal ultrasound findings. This retrospective cohort study included 87 pregnant women referred for genetic counseling because of abnormal first-trimester ultrasound findings between July 2022 and December 2025. All patients received standardized prenatal genetic counseling. Clinical data were extracted from the medical records, and factors associated with the selection of invasive diagnostic testing were analyzed using multivariable logistic regression. Amniocentesis was selected in 41 pregnancies (47.1%), NIPT in 28 (32.2%), and no chromosomal testing in 18 (20.7%). Chromosomal abnormalities were identified in 15 of 41 pregnancies (36.6%) undergoing amniocentesis. Cystic hygroma was independently associated with the selection of invasive diagnostic testing (odds ratio [OR] 3.10, 95% confidence interval [CI] 1.09-9.15), whereas increased nuchal translucency was negatively associated (OR 0.35, 95% CI 0.13-0.90). These findings suggest that the type of first-trimester ultrasound abnormality is associated with prenatal test selection. Our results highlight the importance of individualized genetic counseling when discussing prenatal testing options and residual uncertainty following abnormal ultrasound findings.
DOI： 10.1002/jgc4.70286
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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 2026.5
Authorship：Lead author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：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 2026.3
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：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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Population-Based Study of Prenatal Detection of Critical Congenital Heart Disease in Kyu-Yama Region of Japan. Reviewed
Nagata H, Kitadai Y, Hara T, Shinya M, Sugitani Y, Takahashi M, Doi K, Okada S, Shimabukuro A, Doi H, Kozuma Y, Hamada T, Kawamura J, Nishihara T, Teramachi Y, Kan N, Maeno Y, Nishibatake M
Pediatrics international : official journal of the Japan Pediatric Society 68 ( 1 ) e70467 2026.1
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal)
DOI： 10.1111/ped.70467
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高橋 雅子, 土井 宏太郎
Pediatrics international : official journal of the Japan Pediatric Society 68 ( 1 ) e70467 2026
Authorship：Lead author, Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley
Background: The prenatal detection rate (PDR) of congenital heart disease (CHD) has been scarcely reported in Japan. This study aimed to investigate PDR of critical CHD in a region of Japan and to evaluate the impact of prenatal diagnosis on postnatal mortality and severe morbidity.
Materials and Methods: We included patients diagnosed with CHD either prenatally and postnatally between January 1st 2018 and December 31st 2020, based on institutional database. The Kyu-Yama region comprises the seven prefectures of Kyushu island, Yamaguchi prefecture and Okinawa prefecture. Clinical outcome was compared with prenatal vs postnatal diagnosis.
Results: The overall PDR of critical CHD in the region was 64% (400 of 626 cases). Fifty-four (14%) fetuses were diagnosed within 22 weeks of gestational age. Among these cases, termination of pregnancy was selected in 5 (1%) cases. In subgroup analyses by CHD type, heterotaxy had the highest detection rate (91%), followed by hypoplastic left heart syndrome (86%). In contrast, lower detection rates were observed in transposition of the great arteries (43%) and total anomalous pulmonary veinous connection (15%). Detection rates varied by prefectures, ranging from 41% to 75%. Among actively managed cases, overall, there was a significant difference in mortality and severe morbidity between prenatal and postnatal groups [66 (18%) vs. 20 (9%), p=0.0031].
Conclusion: The overall PDR in this regional cohort was favorable; however, substantial differences remained across prefectures and CHD types. Reducing these disparities may require guideline-based education. Further research is warranted to clarify the prognostic impact of prenatal diagnosis.
Books 【 display / non-display 】
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Preterm Labor and Delivery
Koutarou Doi（ Role： Joint author）
Springer 2019.3
Responsible for pages：89-94 Language：English Book type：Scholarly book
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Obstetrical and Gynecological Therapy, The role of university of miyazaki in perinatal emergencies
Koutarou Doi, Tsuyomu Ikenoue,Syuuichi Tokunaga（ Role： Joint author）
NAGAI SHOTENN 2010.4
Language：Japanese Book type：Scholarly book
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The JAPANESE JOURNAL OF PERINATAL CARE 2010
Koutarou Doi, Masatoki Kaneko （ Role： Joint author）
medica syuppann 2010.1
Language：Japanese Book type：Scholarly book
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perinatal emergencies, Obstetrical DIC
Koutarou Doi, Seishi Furukawa, Hiroshi Sameshima（ Role： Joint author）
IGAKU SHOIN 2010.1
Language：Japanese Book type：Scholarly book
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周産期管理
土井宏太郎、鮫島浩（ Role： Joint author , 第8章 前置胎盤・癒着胎盤）
メディカ出版 2009
Language：Japanese Book type：Scholarly book
MISC 【 display / non-display 】
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遺伝カウンセリングでつなぐ未来の医療と家族の健康
土井宏太郎
サンテ宮崎 2025
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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妊娠中のアセトアミノフェン使用と児の自閉症,ADHD,知的障害に関する検討(海外文献から)
土井宏太郎
産婦人科の実際 73 ( 7 ) 744 2024.7
Authorship：Lead author Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal)
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遺伝学的検査と遺伝カウンセリング
土井宏太郎
日州医事 2024
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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梅毒と妊娠
土井宏太郎
宮日新聞きゅんと 2023
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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【外来時・入院時】切迫早産妊婦
土井宏太郎
ペリネイタルケア 2022.9
Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
Presentations 【 display / non-display 】
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胎児評価の扉；やさしく学ぶ出生前検査と胎児心エコー
土井宏太郎
宮崎県産婦人科病医院従事者研修会第29回ひむかセミナー 2026.3
Event date： 2026.3.7 - 2026.3.8
Language：Japanese Presentation type：Oral presentation (invited, special)
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胎内発生神経障害のCTG所見
土井宏太郎
日本母体胎児医学会第3回胎児心拍数陣痛図セミナー 2025.9.27
Event date： 2025.9.27 - 2025.9.28
Language：Japanese Presentation type：Oral presentation (general)
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レベル1 初めて学ぶ胎児心エコーの扉
土井宏太郎
第10回九州山口胎児心臓研究会 2025.9.13
Event date： 2025.9.13
Language：Japanese Presentation type：Oral presentation (general)
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周産期に活かす！初めて学ぶ遺伝医学の扉
土井宏太郎
宮崎県産婦人科病医院従事者研修会第28回ひむかセミナー 2025.3.1
Event date： 2025.3.1 - 2025.3.2
Language：Japanese Presentation type：Oral presentation (general)
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遺伝医学と生命倫理～周産期遺伝カウンセリングの現場から～
土井宏太郎
宮崎県医師会母体保護法指定医師研修会 2025.2.8
Event date： 2025.2.8
Language：Japanese Presentation type：Oral presentation (general)