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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., 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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Sekine M, Nishijima K, Nakagawa S, Suzuki Y, Murakami T, Kato Y, Umazume T, Tanaka H, Komatsu H, Doi K, Miura K, Kudo Y, Unno N, Kimura T, Enomoto T
The journal of obstetrics and gynaecology research 48 ( 7 ) 1580 - 1590 2022.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research
Aim: We aimed to grasp the actual working hours of Japanese obstetricians and gynecologists (OB/GYN doctors) as accurately as possible, using the same method of the Ministry of Health, Labour, and Welfare (MHLW). Methods: The time study targeted OB/GYN doctors working at 10 universities nationwide including Niigata University and 21 institutions which take a role of perinatal care in Niigata prefecture. Working hours per week were calculated based on the following categories: regular and overtime work inside the hospital, work outside the hospital, self-improvement, education, research, and others. Data on weekly working hours were converted to yearly data for analyses. Results: A time study of 10 universities nationwide revealed that 30% of doctors work overtime for more than 1860 h even if they do not include on-call shifts in their working hours. In 21 institutions in Niigata, physicians in Niigata University worked more overtime than other hospitals. It became clear that community health care was supported by dispatching physicians working at university. Furthermore, the results of simulations predicted the pessimistic situation of perinatal medical care in Niigata. Conclusions: Our study showed the possibility to exist much more OB/GYN doctors who work more than 1860 h of overtime work per year than the data presented by the MHLW based on nation-wide survey in 2019. The fact that the working hours at the side jobs had a great influence on the increase in overtime work of physicians in University was the same result as the report of MHLW published in 2021.
DOI： 10.1111/jog.15230
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Tomimori K., Kodama Y., Tanaka H., Yamashita A., Gi T., Asada Y., Doi K., Katsuragi S., Sato Y.
Virchows Archiv 480 ( 6 ) 1181 - 1187 2022.6
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Virchows Archiv
Transient abnormal myelopoiesis (TAM), also known as transient myeloproliferative disorder or transient leukemia, is a self-regressing neoplasia that afflicts infants with trisomy 21. A recent review article documented “myeloid cell thrombus (MCT)” and “fetal vascular malperfusion (FVM)” in placentas with TAM, although the characteristic TAM placental findings have not been clarified. Here, we compared the clinical and pathological placental findings between trisomy 21 patients with or without TAM. In 13 cases of trisomy 21, we identified six placentas with TAM and seven placentas without TAM. The six placentas with TAM included two stillborn cases. Microscopically, MCT was noted in all the cases, and a high incidence of FVM (50%) was observed in TAM cases. Immunohistochemically, MCT was found to be a platelet-rich thrombus. The placentas were grouped according to the presence or absence of TAM and subsequently compared. Clinically, the incidences of abnormal fetal heart rate pattern and fetal or neonatal death were significantly higher in TAM cases. Pathologically, placenta in TAM cases weighted more than those in cases without TAM, and the incidence of MCT was significantly higher in placentas with TAM. Moreover, the incidence of FVM was higher in placentas with TAM, but this difference was not statistically significant. We propose that MCT is a diagnostic feature of placentas with TAM and may be associated with poor fetal outcomes.
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Takakura S., Kodama Y., Yamashita R., Kino E., Kawano N., Tomimori K., Maki Y., Doi K., Kaneko M., Sameshima H.
Journal of Obstetrics and Gynaecology Research 46 ( 3 ) 389 - 395 2020.3
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research
© 2019 Japan Society of Obstetrics and Gynecology Aim: To investigate the effects of Mycoplasma/Ureaplasma cultured in amniotic fluid on perinatal characteristics in preterm delivery between 22 and 33 weeks of gestation. Methods: The study was conducted in a tertiary perinatal center and involved 38 pregnant women who had undergone amniocentesis to evaluate intrauterine infection due to preterm labor or premature rupture of membranes. The subjects were divided into three groups based on the culture results: negative (Negative Group, n = 24), positive for Mycoplasma/Ureaplasma (M/U Group, n = 6), and positive for other pathogens (Other Pathogens Group, n = 8). One-way analysis of variance was used to compare the three groups. Results: The incidence of histological chorioamnionitis and neonatal sepsis was significantly different among the three groups (the Negative Group and the Other Pathogens Group, P < 0.01; the M/U Group and the Other Pathogens Group, P = 0.03). In the M/U Group, no infants had sepsis, severe intraventricular hemorrhage, cystic periventricular leukomalacia, or poor neurological outcomes, but one infant developed bronchopulmonary dysplasia and needed home oxygen treatment. Although one died of gastrorrhexis, the remaining five patients had normal brain magnetic resonance imaging findings and developed normally. Conclusion: The presence of Mycoplasma/Ureaplasma isolated from amniotic fluid did not cause neonatal sepsis or poor prognosis. In some infants, there was no histological chorioamnionitis in the placenta. These pathogens thus seem to be less invasive than any other microbes with respect to perinatal outcomes.
DOI： 10.1111/jog.14183
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Manual removal of placenta in women having unpredictable adherent placenta Reviewed
Seishi Furukawa, Midori Fujisaki, Yohei Maki, Masanao Ohashi, Koutaro Doi, Hiroshi Sameshima
Journal of Obstetrics and Gynaecology Resarch 45 ( 1 ) 141 - 147 2019.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Obstetrics and Gynaecology Research
Aim: Our aim is to provide expected outcomes for undergoing manual removal of placenta (MROP) following vaginal delivery in women having an unpredictable adherent placenta (AP). Methods: The data were obtained from four hospitals in Miyazaki Prefecture, Japan. We used propensity score-matched (1:1) analysis to match women who underwent MROP with women who did not undergo MROP (control). Total blood loss and hemorrhagic rate used as a ratio of women who reached a certain amount of blood loss were compared. Subgroup analysis was undertaken and was dependent on the presence of AP. We found the cut-off value of blood loss for detecting AP. Results: Thirty-seven MROP cases were identified. Total blood loss and hemorrhagic rate differed significantly between MROP cases and controls; 95% of controls had blood loss of 1000 mL or less, whereas for the MROP cases, it was 14%. Fourteen MROP cases were diagnosed with AP. The hemorrhagic rate differed significantly between MROP cases with and without AP (n = 19); 79% of MROP cases without AP had blood loss of 2000 mL or less, whereas for the MROP cases with AP, it was 7%. There were seven incidents of hysterectomy and two of arterial embolization in MROP cases with AP. Through receiver operating characteristic curve analysis, 2035 mL of blood loss was determined to be the optimal cut-off value for detecting AP. Conclusion: The incidence of unpredictable AP in MROP cases was as high as 38%. The morbidity of MROP cases with unpredictable AP was severe. MROP should be prohibited in the absence of appropriate hemostatic preparations.
DOI： 10.1111/jog.13805
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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【悩めるCTG 20ケース 事例で理解 ドクターコールのタイミングと助産ケア】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 41 ( 9 ) 858 - 863 2022.9
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)
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)