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所属 |
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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職名 |
講師 |
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外部リンク |
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関連SDGs |
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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
担当区分：筆頭著者, 責任著者 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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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年7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 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年6月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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 査読あり
Seishi Furukawa, Midori Fujisaki, Yohei Maki, Masanao Ohashi, Koutaro Doi, Hiroshi Sameshima
Journal of Obstetrics and Gynaecology Resarch 45 ( 1 ) 141 - 147 2019年1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 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
書籍等出版物 【 表示 ／ 非表示 】
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Preterm Labor and Delivery
Koutarou Doi（ 担当： 共著）
Springer 2019年3月
担当ページ：89-94 記述言語：英語 著書種別：学術書
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産婦人科治療 2010 Vol.100 増刊 産婦人科救急のすべて A.総論 ８．わが教室における周産期救急医療（共著）
土井宏太郎，池ノ上克，徳永修一（ 担当： 共著 , 範囲: 6）
永井書店 2010年4月
記述言語：日本語 著書種別：学術書
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ペリネイタルケア 2010年 新春増刊 妊婦健康診査 パーフェクトマニュアル 第３章 検査・スクリーニング 胎盤位置異常（共著）
土井宏太郎，金子政時（ 担当： 共著 , 範囲: 8）
メディカ出版 2010年1月
記述言語：日本語 著書種別：学術書
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臨床婦人科産科 第64巻第１号 母体救命搬送<救急搬送のタイミングと応急処置1.緊急に救命処置が必要な産科疾患 ２> 産科ＤＩＣ（共著）
土井宏太郎，古川誠志，鮫島浩（ 担当： 共著 , 範囲: 5）
医学書院 2010年1月
記述言語：日本語 著書種別：学術書
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周産期管理
土井宏太郎、鮫島浩（ 担当： 共著 , 範囲: 第8章 前置胎盤・癒着胎盤）
メディカ出版 2009年
記述言語：日本語 著書種別：学術書
MISC 【 表示 ／ 非表示 】
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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年
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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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年7月
担当区分：筆頭著者 記述言語：日本語 掲載種別：速報，短報，研究ノート等（学術雑誌）
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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年
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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梅毒と妊娠
土井宏太郎
宮日新聞きゅんと 2023年
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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【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年9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）
講演・口頭発表等 【 表示 ／ 非表示 】
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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年3月
開催年月日： 2026年3月7日 - 2026年3月8日
記述言語：日本語 会議種別：口頭発表（招待・特別）
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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年9月27日
開催年月日： 2025年9月27日 - 2025年9月28日
記述言語：日本語 会議種別：口頭発表（一般）
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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年9月13日
開催年月日： 2025年9月13日
記述言語：日本語 会議種別：口頭発表（一般）
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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年3月1日
開催年月日： 2025年3月1日 - 2025年3月2日
記述言語：日本語 会議種別：口頭発表（一般）
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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年2月8日
開催年月日： 2025年2月8日
記述言語：日本語 会議種別：口頭発表（一般）