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医学部 附属病院 産科・婦人科 |
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講師 |
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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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Fujisaki M., Furukawa S., Maki Y., Oohashi M., Doi K., Sameshima H.
Journal of Pregnancy 2017 8318751 2017年
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 Pregnancy
© 2017 Midori Fujisaki et al. Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP) by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone) were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186±1438 ml versus 1656±848 ml, resp.; p=0.34). Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity.
DOI： 10.1155/2017/8318751
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The effect of placental abruption on the outcome of extremely premature infants 査読あり
Furukawa S., Doi K., Furuta K., Sameshima H.
Journal of Maternal-Fetal and Neonatal Medicine 28 ( 6 ) 705 - 708 2015年4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 Maternal-Fetal and Neonatal Medicine
© 2014 Informa UK Ltd. All rights reserved. Objective: To determine the effect of placental abruption on the outcome of infants born between 22 and 26 weeks of gestation. Methods: A retrospective study involving 32 cases of placental abruption. Controls were matched to cases according to gestational age and birth weight. Medical records were reviewed to confirm maternal background and neonatal outcome. We compared characteristics of maternal background and neonatal outcome between the two groups. Results: There were no significant differences in the incidence of pregnancy-induced hypertension, low maternal fibrinogen (<200 mg/dl), premature rupture of membrane, intrauterine infection, ischemic changes of the placenta, or funisitis between the groups. Non-reassuring fetal heart rate patterns (NRFHRs) during intrapartum were frequently seen in the placental abruption group compared to controls (75% versus 51%, p = 0.02). However, no differences were found for the incidence of low umbilical artery pH (<7.1), cerebral palsy, or neonatal death. The incidence of chronic lung disease (CLD, 66% versus 43%, p = 0.04) and hemosiderin deposition on the placenta (16% versus 0%, p < 0.01) was higher in abruptions compared to controls. Conclusion: Placental abruption has a risk for the development of NRFHRs and CLD in infants born between 22 and 26 weeks of gestation, but shows no effect on neonatal mortality.
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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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分娩時羊水混濁への対応 招待あり
土井宏太郎、古川誠志、鮫島浩
周産期医学 49 ( 1 ) 111 - 113 2019年1月
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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脳性麻痺発症の防止に対する助産所・診療所と専門病院との連携 招待あり
池ノ上克、児玉由紀、山下理絵、土井宏太郎、鮫島浩
公衆衛生 82 ( 7 ) 544 - 547 2018年7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）
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変動一過性徐脈
土井宏太郎
ペリネイタルケア 36 ( 5 ) 470 - 473 2017年5月
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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力だめし症例8問！
古川誠志、古田賢、大橋昌尚、紀愛美、児玉由紀、椎葉望、土井宏太郎、藤﨑碧、道方香織
ペリネイタルケア 36 ( 5 ) 438 - 446 2017年5月
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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CTGケースプレゼンテーションCase35 招待あり
土井宏太郎
ペリネイタルケア 35 ( 11 ) 1042 - 1045 2016年11月
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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周産期脳障害と胎児心拍数モニタリング～地域FHRネットワークシステムの紹介～ 招待あり
土井宏太郎
第222回熊本周産期懇話会
開催年月日： 2019年11月20日
記述言語：日本語 会議種別：口頭発表（招待・特別）
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当院における出生前診断の現状
安達容枝、山口昌俊、伊井美奈代、土井宏太郎、山田直史、丸山るり子、鮫島浩
日本人類遺伝学会第64回大会
開催年月日： 2019年11月6日 - 2019年11月9日
記述言語：日本語 会議種別：ポスター発表
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Closing gastroschisisの一例
菅野知佳、徳田温子、山口智子、山田直史、土井宏太郎、山下理絵、入佐浩史、黒木亜津子、枡屋隆太、中目和彦、児玉由紀、金子政時、鮫島浩
第75回九州新生児研究会
開催年月日： 2019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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先天梅毒2症例の周産期経過
徳田温子、菅野知佳、後藤裕磨、山口智子、紀愛美、松澤聡史、牧洋平、山田直史、牛嶋順子、土井宏太郎、山下理絵、古川誠志、川越靖之、児玉由紀、金子政時、鮫島浩
令和元年度宮崎県産婦人科医会・宮崎県産科婦人科学会合同秋期定時総会
開催年月日： 2019年9月14日
記述言語：日本語 会議種別：口頭発表（一般）
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迅速な抗菌薬治療により救命し得た劇症型GAS感染症の1例
伊達木正子、松澤聡史、三部一輝、後藤裕磨、紀愛美、牧洋平、牛嶋順子、土井宏太郎、古川誠志、川越靖之、児玉由紀、鮫島浩
令和元年度宮崎県産婦人科医会・宮崎県産科婦人科学会合同秋期定時総会
開催年月日： 2019年9月14日
記述言語：日本語 会議種別：口頭発表（一般）