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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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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
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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
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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【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年9月
掲載種別：記事・総説・解説・論説等（学術雑誌）
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産科領域：コンピュータサイエンス・エンジニアリングの進歩 ICTのFHRモニタリングへ応用
土井宏太郎
周産期医学 2022年7月
掲載種別：記事・総説・解説・論説等（学術雑誌）
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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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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）
講演・口頭発表等 【 表示 ／ 非表示 】
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周産期医療と医療倫理
土井宏太郎
令和5年度宮崎胃炎医師会母体保護法指定医師研修会
開催年月日： 2024年3月16日
会議種別：口頭発表（招待・特別）
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臨床現場におけるCGCの役割、院内連携について
土井宏太郎
第29回出生前から小児期にわたるゲノム医療フォーラム
開催年月日： 2023年11月5日
会議種別：口頭発表（一般）
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宮崎大学医学部附属病院遺伝カウンセリング部の現状と問題点
土井宏太郎
第29回出生前から小児期にわたるゲノム医療フォーラム
開催年月日： 2023年11月5日
会議種別：口頭発表（一般）
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前置癒着胎盤における大動脈遮断バルーンカテーテルの使用経験
土井宏太郎
第31回日本胎盤学会学術集会・第41回日本絨毛性疾患研究会
開催年月日： 2023年11月3日 - 2023年11月4日
会議種別：ポスター発表
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当院で対応した無介助分娩希望の2症例
土井宏太郎
令和5年度宮崎県母性衛生学会総会・学術集会
開催年月日： 2023年10月28日
会議種別：口頭発表（一般）