107 results on '"Nobuhiro Hidaka"'
Search Results
2. Prenatal imaging of a fetus with the rare combination of Pfeiffer syndrome and hypoplastic left heart syndrome
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Yuzo Kitadai, Nobuhiro Hidaka, Masahiro Sumie, Naoyuki Nakanami, Nobuhiko Kan, Yoichiro Serita, and Kiyomi Tsukimori
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Fetus ,Pregnancy ,Hypoplastic Left Heart Syndrome ,Humans ,Radiology, Nuclear Medicine and imaging ,Female ,General Medicine ,Acrocephalosyndactylia ,Ultrasonography, Prenatal - Published
- 2022
3. Evaluation of the efficacy of vaginal progesterone in preventing preterm birth after abdominal trachelectomy: a prospective study with a historical cohort
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Yuka Sato, Nobuhiro Hidaka, Atsuhiko Sakai, Saki Kido, Yasuyuki Fujita, Kaoru Okugawa, Hideaki Yahata, and Kiyoko Kato
- Abstract
Objective To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer Design Prospective cohort study with a historical cohort Setting University hospital Population Twelve pregnancies in ten women were included in the VP group between October 2016 and September 2020. By contrast, 19 pregnancies in 17 women were included in the historical control group between January 2007 and September 2016. Methods For the interventional study participants, the administration of vaginal progesterone was started between 16+0 and 19+6 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery, rupture of membranes, or massive uterine bleeding, whichever occurred first. We investigated obstetric and neonatal outcomes among the study participants and compared them with outcomes of the historical control group participants. Main Outcome Measures The gestational age at delivery and incidence of preterm birth before 37 weeks and 34 weeks of gestation Results The incidence of preterm birth at
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- 2022
4. Massive atonic bleeding during cesarean delivery in a patient with chronic idiopathic intestinal pseudo‐obstruction: A case report and literature review
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Shotaro Kai, Takahiro Nakano, Saki Kido, Yoshihiro Katayama, Kiyoko Kato, and Nobuhiro Hidaka
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Fetus ,Pregnancy ,medicine.medical_specialty ,business.industry ,Lochia ,Obstetrics and Gynecology ,Megacystis ,Disease ,Microcolon ,medicine.disease ,Surgery ,Uterine atony ,Medicine ,Gestation ,business - Abstract
A 35-year-old primigravid woman with chronic idiopathic intestinal pseudo-obstruction presented to our institution. Except for an enlarged fetal bladder, her pregnancy was almost uneventful until she developed pre-eclampsia requiring emergent cesarean section at 34 weeks gestation. After delivery, intractable uterine atony developed with blood loss reaching 3500 mL within 15 min. Following a B-Lynch suture, the bleeding attenuated but uterine atony persisted; lochia persisted for 3 months post-partum. The infant was diagnosed with megacystis microcolon intestinal hypoperistalsis syndrome after birth. The mother's clinical course and previous reports suggested that atonic bleeding was associated with the pathology of chronic idiopathic intestinal pseudo-obstruction; the infant's disease was considered to be maternal-related disease. Clinicians should be vigilant in pregnant patients with chronic idiopathic intestinal pseudo-obstruction especially with these complications.
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- 2020
5. Intrathoracic shunt displacement with massive pleural effusion after successful shunt placement in a hydropic fetus with multilocular macrocystic congenital pulmonary airway malformation
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Saki Kido, Nobuhiro Hidaka, Kiyoko Kato, Asako Hara, Atsuhiko Sakai, and Kenta Nitahara
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Fetus ,medicine.medical_specialty ,Lung ,Pleural effusion ,Thoracic cavity ,business.industry ,Congenital pulmonary airway malformation ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,Shunt (medical) ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Hydrops fetalis ,medicine ,Radiology, Nuclear Medicine and imaging ,Cyst ,business - Abstract
We successfully performed shunting for a fetus with a multilocular macrocystic lung mass with hydrops at 22 weeks' gestation. Complete resolution of hydrops was achieved; however, at 35 weeks' gestation, the fetus developed acute massive pleural effusion. Fetal ultrasound examination revealed that one end of the shunting tube had migrated downward in the thoracic cavity, which led to fluid draining from the lung cyst. The baby was delivered at term and was discharged following neonatal intensive care management. Intrathoracic displacement of the shunt can occur, followed by massive pleural effusion due to drainage of cystic fluid.
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- 2020
6. Gastric cancer during pregnancy with placental involvement: case report and review of published works
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Yasuyuki Fujita, Hiroshi Tomonobe, Seiya Oga, Masahiro Hachisuga, Nobuhiro Hidaka, Hidetaka Yamamoto, and Kiyoko Kato
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medicine.medical_specialty ,villous invasion ,Case Report ,Gastroenterology ,lcsh:Gynecology and obstetrics ,Metastasis ,Maternal-Fetal Medicine ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Biopsy ,medicine ,lcsh:RG1-991 ,Pregnancy ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Esophagogastroduodenoscopy ,business.industry ,Stomach ,gastric cancer ,Obstetrics and Gynecology ,Cancer ,placental metastasis ,Intervillous space ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Adenocarcinoma ,pregnancy ,business - Abstract
Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the stomach confirmed the diagnosis of gastric cancer. Her epigastric and back pain became more pronounced and her general status worsened, and we performed a cesarean delivery at 29 weeks. Microscopic examination of the placental specimen revealed poorly differentiated adenocarcinoma cells diffused into the intervillous space. Postpartum chemotherapy consisted of S-1 plus oxaliplatin. Unfortunately, this treatment was ineffective, and the patient died 3 months after delivery. The infant did well, without clinical or laboratory manifestations of metastasis. In patients with advanced gastric cancer during pregnancy, it is important to perform a microscopic examination of the placenta to evaluate for metastatic involvement.
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- 2019
7. A case of fetal macrocystic CPAM in which associated hydrops did not resolve despite fetal therapy resulting in worsened mirror syndrome and early neonatal death
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Masahiro Hachisuga, Ririko Izumi, Takahiro Nakano, Kiyoko Kato, Saki Kido, Shotaro Kai, and Nobuhiro Hidaka
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medicine.medical_specialty ,Fetus ,Obstetrics ,business.industry ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,medicine.disease ,Fetal therapy ,Mirror syndrome ,Early neonatal death - Published
- 2019
8. Prenatal diagnosis of ectopic intrathoracic kidney with right congenital diaphragmatic hernia manifesting as fetal mesocardia
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Yusuke Yanagi, Nobuhiro Hidaka, Masahiro Hachisuga, Kiyoko Kato, Mariko Saruwatari, Saki Kido, Shotaro Kai, Tomoaki Taguchi, and Takahiro Nakano
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Mesocardia ,medicine.medical_specialty ,Fetus ,Kidney ,medicine.anatomical_structure ,business.industry ,medicine ,Congenital diaphragmatic hernia ,Radiology, Nuclear Medicine and imaging ,Prenatal diagnosis ,medicine.disease ,business ,Surgery - Published
- 2019
9. Evaluation of the efficacy of vaginal progesterone in preventing preterm birth after abdominal trachelectomy
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Nobuhiro Hidaka, Yuka Sato, Atsuhiko Sakai, Kiyoko Kato, Hideaki Yahata, Kaoru Okugawa, Yasuyuki Fujita, and Saki Kido
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medicine.medical_specialty ,Abdominal trachelectomy ,Trachelectomy ,Cervix Uteri ,Pregnancy ,Medicine ,Rupture of membranes ,Humans ,Preterm premature membranes rupture ,Vaginal progesterone ,Progesterone ,Cervical cancer ,business.industry ,Obstetrics ,Incidence (epidemiology) ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,Preterm birth ,medicine.disease ,Exact test ,Administration, Intravaginal ,Reproductive Medicine ,Mann–Whitney U test ,Gestation ,Premature Birth ,Female ,Progestins ,business - Abstract
Objective: To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer / Study Design: This is an interventional study with a historical cohort. For the interventional study participants who had singleton pregnancies after AT between October 2016 and September 2020, the administration of vaginal progesterone was started between 16+ and 19+6 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery, rupture of membranes, or massive uterine bleeding. We investigated obstetric and neonatal outcomes among the study participants and compared them with outcomes of the historical control group participants, included women with singleton pregnancies after AT who were managed without VP at our institution between January 2007 and September 2016, using Fisher’s exact test and the Mann–Whitney U test The main outcomes were the gestational age at delivery and incidence of preterm birth before 37 weeks and 34 weeks of gestation. / Result: Twelve pregnancies in ten women were included in the VP group. In contrast, 19 pregnancies in 17 women were included in the historical control group. The incidence of preterm birth at
- Published
- 2020
10. Adverse intrapartum outcome in pregnancies complicated by small for gestational age and late fetal growth restriction undergoing induction of labor with Dinoprostone, Misoprostol or mechanical methods: A systematic review and meta-analysis
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Alessandra Familiari, Patrizia Vergani, Vincenzo Berghella, Marco Liberati, Franz Bahlmann, E. V. Cosmi, Chinedu Nwabuobi, Francesco D'Antonio, Federico Mecacci, Anthony Odibo, Maria Elena Flacco, Carlotta Iacovella, Asma Khalil, Giuseppe Rizzo, Cecilia Acuti Martellucci, L Manzoli, Karen Melchiorre, Luigi Nappi, Alice D'Amico, Silvia Visentin, Danilo Buca, Giovanni Scambia, Nobuhiro Hidaka, Daniele Di Mascio, Serena Simeone, Familiari, Alessandra, Khalil, Asma, Rizzo, Giuseppe, Odibo, Anthony, Vergani, Patrizia, Buca, Danilo, Hidaka, Nobuhiro, Di Mascio, Daniele, Nwabuobi, Chinedu, Simeone, Serena, Mecacci, Federico, Visentin, Silvia, Cosmi, Eric, Liberati, Marco, D’Amico, Alice, Flacco, Maria Elena, Martellucci, Cecilia Acuti, Manzoli, Lamberto, Nappi, Luigi, Iacovella, Carlotta, Bahlmann, Franz, Melchiorre, Karen, Scambia, Giovanni, Berghella, Vincenzo, D’Antonio, Francesco, Familiari, A, Khalil, A, Rizzo, G, Odibo, A, Vergani, P, Buca, D, Hidaka, N, Di Mascio, D, Nwabuobi, C, Simeone, S, Mecacci, F, Visentin, S, Cosmi, E, Liberati, M, D'Amico, A, Flacco, M, Martellucci, C, Manzoli, L, Nappi, L, Iacovella, C, Bahlmann, F, Melchiorre, K, Scambia, G, Berghella, V, and D'Antonio, F
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medicine.medical_specialty ,Foley balloon catheter ,Population ,Socio-culturale ,Gestational Age ,Dinoprostone ,Ultrasonography, Prenatal ,Pregnancy ,Prenatal ,Humans ,Medicine ,IOL ,Labor, Induced ,education ,Misoprostol ,Induction of labor ,SGA ,FGR ,Ultrasonography ,education.field_of_study ,Fetus ,Fetal Growth Retardation ,Cesarean Section ,business.industry ,Obstetrics ,Cook balloon catheter ,Induced ,Infant, Newborn ,Infant ,Obstetrics and Gynecology ,Newborn ,medicine.disease ,Labor ,Reproductive Medicine ,Settore MED/40 ,Meta-analysis ,Infant, Small for Gestational Age ,Small for Gestational Age ,Small for gestational age ,Female ,business ,Uterine tachysystole ,medicine.drug - Abstract
Objective: To investigate the outcome of pregnancies with small baby, including both small for gestational age (SGA) and late fetal growth restriction (FGR) fetuses, undergoing induction of labor (IOL) with Dinoprostone, Misoprostol or mechanical methods. Study design: Medline, Embase and Cochrane databases were searched. Inclusion criteria were non-anomalous singleton pregnancies complicated by the presence of a small fetus, defined as a fetus with estimated fetal weight (EFW) or abdominal circumference (AC) 3rd centile with normal cerebroplacental Dopplers). Quality assessment of each included study was performed using the Risk of Bias in Non-randomized Studies-of Interventions tool (ROBINS-I), while the GRADE methodology was used to assess the quality of the body of retrieved evidence. Meta-analyses of proportions and individual data random-effect logistic regression were used to analyze the data. Results: 12 studies (1711 pregnancies) were included. In the overall population of small fetuses, composite adverse intra-partum outcome occurred in 21.2 % (95 % CI 10.0−34.9) of pregnancies induced with Dinoprostone, 18.0 % (95 % CI 6.9−32.5) of those with Misoprostol and 11.6 % (95 % CI 5.5−19.3) of those undergoing IOL with mechanical methods. Cesarean section (CS) for non-reassuring fetal status (NRFS) was required in 18.1 % (95 % CI 9.9−28.3) of pregnancies induced with Dinoprostone, 9.4 % (95 % CI 1.4−22.0) of those with Misoprostol and 8.1 % (95 % CI 5.0−11.6) of those undergoing mechanical induction. Likewise, uterine tachysystole, was recorded on CTG in 13.8 % (95 % CI 6.9−22.3) of cases induced with Dinoprostone, 7.5 % (95 % CI 2.1−15.4) of those with Misoprostol and 3.8 % (95 % CI 0–4.4) of those induced with mechanical methods. Composite adverse perinatal outcome following delivery complicated 2.9 % (95 % CI 0.5−6.7) newborns after IOL with Dinoprostone, 0.6 % (95 % CI 0–2.5) with Misoprostol and 0.7 % (95 % CI 0–7.1) with mechanical methods. In pregnancies complicated by late FGR, adverse intrapartum outcome occurred in 25.3 % (95 % CI 18.8−32.5) of women undergoing IOL with Dinoprostone, compared to 7.4 % (95 % CI 3.9−11.7) of those with mechanical methods, while CS for NRFS was performed in 23.8 % (95 % CI 17.3−30.9) and 6.2 % (95 % CI 2.8−10.5) of the cases, respectively. Finally, in SGA fetuses, composite adverse intrapartum outcome complicated 8.4 % (95 % CI 4.6−13.0) of pregnancies induced with Dinoprostone, 18.6 % (95 % CI 13.1−25.2) of those with Misoprostol and 8.7 (95 % CI 2.5−17.5) of those undergoing mechanical IOL, while CS for NRF was performed in 8.4 % (95 % CI 4.6−13.0) of women induced with Dinoprostone, 18.6 % (95 % CI 13.1−25.2) of those with Misoprostol and 8.7 % (95 % CI 2.5−17.5) of those undergoing mechanical induction. Overall, the quality of the included studies was low and was downgraded due to considerable clinical and statistical heterogeneity. Conclusions: There is limited evidence on the optimal type of IOL in pregnancies with small fetuses. Mechanical methods seem to be associated with a lower occurrence of adverse intrapartum outcomes, but a direct comparison between different techniques could not be performed.
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- 2020
11. The impact of general anesthesia on mother-infant bonding for puerperants who undergo emergency cesarean deliveries
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Kiyoko Kato, Kenta Nitahara, Saki Kido, Atsuhiko Sakai, and Nobuhiro Hidaka
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Anesthesia, Epidural ,Aftercare ,Context (language use) ,Anesthesia, General ,Teaching hospital ,03 medical and health sciences ,0302 clinical medicine ,Japan ,030202 anesthesiology ,Interquartile range ,Pregnancy ,Surveys and Questionnaires ,Medicine ,Anesthesia, Obstetrical ,Humans ,030212 general & internal medicine ,Risk factor ,Emergency Treatment ,Emergency Cesarean Delivery ,Retrospective Studies ,business.industry ,Cesarean Section ,Postpartum Period ,Infant, Newborn ,Obstetrics and Gynecology ,Mother infant bonding ,Object Attachment ,Confidence interval ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Propensity score matching ,Maternal-Fetal Relations ,Female ,business - Abstract
BackgroundMother-infant bonding is an emerging perinatal issue. While emergency cesarean deliveries are associated with a risk of bonding disorders, the mode of anesthesia used for emergency cesarean deliveries has never been studied in this context. We aimed to investigate the impact of administering general anesthesia and neuraxial anesthesia to women undergoing cesarean deliveries on mother-infant bonding.MethodsThis was a retrospective, propensity score-matched multivariable analysis of 457 patients who underwent emergency cesarean deliveries between February 2016 and January 2019 at a single teaching hospital in Japan. The Mother-Infant Bonding Scale (MIBS) scores at hospital discharge and the 1-month postpartum outpatient visit were evaluated in the general anesthesia and the neuraxial anesthesia groups. A high score on the MIBS indicates impaired mother-infant bonding.ResultsThe primary outcome was the MIBS score at hospital discharge in propensity score-matched women. After propensity score matching, the median [interquartile range (IQR)] MIBS scores were significantly higher in the general anesthesia group than those in the neuraxial anesthesia group at hospital discharge [2 (1–4) vs. 2 (0–2); P = 0.015] and at the 1-month postpartum outpatient visit [1 (1–3) vs. 1 (0–2); P = 0.046]. In linear regression analysis of matched populations, general anesthesia showed a significant and positive association with the MIBS scores at hospital discharge [beta coefficient 0.867 (95% confidence interval [CI] 0.147–1.59); P = 0.019] but not at the 1-month postpartum outpatient visit [0.455 (−0.134 to 1.044); P = 0.129].ConclusionGeneral anesthesia for emergency cesarean delivery is an independent risk factor associated with impaired mother-infant bonding.
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- 2019
12. Fibrosis in Preeclamptic Placentas Is Associated with Stromal Fibroblasts Activated by the Transforming Growth Factor-β1 Signaling Pathway
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Yasuyuki Fujita, Hiroshi Yagi, Mai Fujikawa, Kazuo Asanoma, Takako Ohmaru-Nakanishi, Kiyoko Kato, Ichiro Onoyama, Kenzo Sonoda, and Nobuhiro Hidaka
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Adult ,0301 basic medicine ,Placenta ,medicine.medical_treatment ,Connective tissue ,Pathology and Forensic Medicine ,Transforming Growth Factor beta1 ,Mothers against decapentaplegic homolog 2 ,Andrology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Fibrosis ,medicine ,Humans ,biology ,Chemistry ,Growth factor ,Fibroblasts ,medicine.disease ,Blot ,Fibronectin ,030104 developmental biology ,medicine.anatomical_structure ,Case-Control Studies ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Stromal Cells ,Signal transduction ,Signal Transduction ,Transforming growth factor - Abstract
Although fibrosis is one of the most prominent pathologic features of preeclamptic (PE) placentas, its mechanism remains largely unknown. Consistent with previous reports, we observed overexpression of collagen; actin, α2, smooth muscle, aorta; connective tissue growth factor; and fibronectin in PE placentas compared with control ones. To investigate the mechanism of fibrosis in PE placentas, placental fibroblasts were isolated from PE placentas or normal pregnancies at delivery. The expression of fibrosis-related factors in fibroblasts was evaluated by real-time RT-PCR, Western blotting, enzyme-linked immunosorbent assay, and gene microarrays. An in vitro collagen gel contraction assay was also performed. Fibroblasts isolated from PE placentas showed higher expression levels of fibrosis-related factors compared with those from control ones. Global gene expression profiling of PE fibroblasts was contrasted with that of control ones and indicated an intimate association with transforming growth factor-β1 (TGFB1) signaling. Furthermore, the PE fibroblasts expressed abundant phosphorylated SMAD family member 2 and showed higher expression levels of target genes of TGFB1 signaling compared with the control ones. The PE fibroblasts also had a greater ability to contract compared with the control ones. Contractility also depended on TGFB1 signaling. Our results suggest that TGFB1 signaling is activated in the fibroblasts in PE placentas and that these active fibroblasts contribute to fibrosis.
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- 2018
13. Ductus venosus Doppler and the postnatal outcomes of growth restricted fetuses with absent end-diastolic blood flow in the umbilical arteries
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Yasuyuki Fujita, Yuka Sato, Nobuhiro Hidaka, Kiyoko Kato, and Saki Kido
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Adult ,medicine.medical_specialty ,Diastole ,Placental insufficiency ,lcsh:Gynecology and obstetrics ,Umbilical cord ,Ultrasonography, Prenatal ,Umbilical Arteries ,Young Adult ,03 medical and health sciences ,Fetus ,0302 clinical medicine ,Pregnancy ,medicine.artery ,Laser-Doppler Flowmetry ,Humans ,Medicine ,030212 general & internal medicine ,lcsh:RG1-991 ,Retrospective Studies ,Fetal Growth Retardation ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Fetal growth restriction ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,Umbilical artery ,Ductus venosus ,Blood flow ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Absent end-diastolic flow in the umbilical artery ,Female ,business ,Blood Flow Velocity - Abstract
Objective We aimed to evaluate the outcomes of growth-restricted fetuses with absent end-diastolic velocity in the umbilical arteries (UA-AEDV), and investigate the relationship between Doppler flow velocity waveforms in the ductus venosus (DV) and the clinical features. Materials and methods This was a retrospective study of growth-restricted fetuses diagnosed with UA-AEDV delivered at our institution between 2013 and 2015. The time from diagnosis of UA-AEDV to delivery, postnatal survival, and developmental prognoses were the primary outcomes. The time lag between the occurrence of UA-AEDV and an abnormal increase in the DV pulsatility index (DV-PI) were investigated. We also examined the correlation between the DV-PI values immediately before birth and umbilical cord arterial pH at birth. Results The median gestational age at birth among the 18 subjects was 28+2 (24+0–34+6) weeks, and the observation period between the first detection of UA-AEDV and delivery ranged from 0 to 35 days with a median of 8 days. Among the 18 infants, 15 (83%) survived, among whom 2 were diagnosed with a developmental disability. Gestational age at delivery was significantly lower in the poor outcome group. A positive correlation (correlation coefficient, 0.68) was observed between the umbilical artery pH and the last measured DV-PI. Conclusion The time interval from initial detection of UA-AEDV to delivery is highly variable, and it is reasonable to manage these growth-restricted fetuses with UA-AEDV expectantly with careful surveillance for fetal well-being. Specifically, Doppler DV analysis is clinically valuable for their evaluation.
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- 2017
14. Re-evaluation of lung to thorax transverse area ratio immediately before birth in predicting postnatal short-term outcomes of fetuses with isolated left-sided congenital diaphragmatic hernia: A single center analysis
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Saki Kido, Yuka Sato, Yasuyuki Fujita, Kina Miyoshi, Kouji Nagata, Tomoaki Taguchi, Kiyoko Kato, and Nobuhiro Hidaka
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Thorax ,Embryology ,medicine.medical_specialty ,viruses ,medicine.medical_treatment ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,medicine ,Rank correlation ,Mechanical ventilation ,Fetus ,030219 obstetrics & reproductive medicine ,Lung ,business.industry ,Congenital diaphragmatic hernia ,General Medicine ,medicine.disease ,Surgery ,Exact test ,medicine.anatomical_structure ,Anesthesia ,Pediatrics, Perinatology and Child Health ,business ,Developmental Biology - Abstract
We aimed to investigate whether the lung-to-thorax transverse area ratio (LTR) immediately before birth is of diagnostic value for the prediction of postnatal short-term outcomes in cases of isolated left-sided congenital diaphragmatic hernia (CDH). We retrospectively reviewed the cases of fetal isolated left-sided CDH managed at our institution between April 2008 and July 2016. We divided the patients into two groups based on LTR immediately before birth, using a cut-off value of 0.08. We compared the proportions of subjects within the two groups who survived until discharge using Fisher's exact test. Further, using Spearman's rank correlation, we assessed whether LTR was correlated with length of stay, duration of mechanical ventilation, and supplemental oxygen. Twenty-nine subjects were included (five with LTR < 0.08, and 24 with LTR ≥ 0.08). The proportion of subjects surviving until discharge was 40% (2/5) for patients with LTR < 0.08, as compared with 96% (23/24) for those with LTR ≥ 0.08. LTR measured immediately before birth was negatively correlated with the postnatal length of stay (Spearman's rank correlation coefficient, rs = -0.486), and the duration of supplemental oxygen (rs = -0.537). Further, the duration of mechanical ventilation was longer in patients with a lower LTR value. LTR immediately before birth is useful for the prediction of postnatal short-term outcomes in fetuses with isolated left-sided CDH. In particular, patients with prenatal LTR value less than 0.08 are at increased risk of postnatal death.
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- 2017
15. Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review
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Kenzo Sonoda, Kaoru Okugawa, Kiyoko Kato, Eisuke Kaneki, Nobuhiro Hidaka, Hiroaki Kobayashi, Yasuyuki Fujita, Hideaki Yahata, Katsuko Egashira, and Yoshiaki Kawano
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Adult ,medicine.medical_specialty ,Pregnancy Rate ,Trachelectomy ,Uterine Cervical Neoplasms ,Adenocarcinoma ,Young Adult ,03 medical and health sciences ,Gynecologic Surgical Procedures ,0302 clinical medicine ,Pregnancy ,Abdomen ,Humans ,Medicine ,Cervix ,Retrospective Studies ,Cervical cancer ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Medical record ,Pregnancy Outcome ,Fertility Preservation ,Hematology ,General Medicine ,medicine.disease ,Institutional review board ,Surgery ,Pregnancy Complications ,Pregnancy rate ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,Varices ,business ,Organ Sparing Treatments - Abstract
Trachelectomy was developed as a fertility-sparing surgery for early-stage cervical cancer in patients of childbearing age. The purpose of this study is to evaluate oncologic and obstetric outcomes and complications after abdominal trachelectomy. We began to perform abdominal trachelectomy in 2005. Our institutional review board approved this clinical study, and fully informed consent was obtained from each patient. The medical records of patients who underwent trachelectomy were retrospectively reviewed. We performed 151 abdominal trachelectomies (89 radical trachelectomies, 48 modified radical trachelectomies, and 14 simple trachelectomies). The median age of the patients was 33 years, and the median postoperative follow-up period was 61 months. Although one patient experienced recurrence at the preserved cervix, none died after treatment. A total of 61 patients attempted to conceive after trachelectomy, and 21 pregnancies were achieved in 15 women. Hence, the pregnancy rate among patients who attempted to conceive was 25%. Fifteen babies were delivered by cesarean section between gestational weeks 23 and 37. Six babies were delivered at term. Six cases of preterm premature rupture of the membranes occurred. Varices appeared around the uterovaginal anastomotic site in five patients. Our data indicate that the oncologic outcome was excellent but infertility treatment was necessary to achieve the majority of conceptions. Additionally, preterm premature rupture of the membranes and premature delivery were frequently observed. An improved pregnancy rate and prevention of complications during pregnancy are issues that should be addressed in future studies.
- Published
- 2016
16. Prolongation of Second Twin’s Delivery Until Term: A Rare Case of Delayed-Interval Delivery
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Nobuhiro Hidaka, Kiyoko Kato, Yuzo Imachi, Shotaro Kai, and Masahiro Hachisuga
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Adult ,030213 general clinical medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,Chorioamnionitis ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Rare case ,medicine ,Humans ,Cervical cerclage ,Full Term ,Community and Home Care ,Second twin ,Obstetrics ,business.industry ,Prolongation ,General Medicine ,medicine.disease ,Ritodrine ,Pregnancy, Twin ,Gestation ,Premature Birth ,Female ,business ,medicine.drug - Abstract
Although some cases describing delayed birth of the second twin have been published recently, delay of delivery beyond 36 weeks seems scarce. We report a case of delayed-interval delivery wherein prolongation of the second twin's delivery until term with a subsequent favorable infantile outcome. In this case, the stillbirth of the first twin occurred at 25 weeks' gestation. Prophylactic tocolysis was performed with ritodrine and magnesium sulfate, and a McDonald cerclage was performed 2 days after delivery of the first twin. Ampicillin and gentamicin were also administered for the purpose of prevention of intrauterine infection. No clinical sign of chorioamnionitis was found thereafter, and full term uneventful delivery was achieved. With this experience, we believe that delayed-interval delivery can be effective in prolonging gestation and should be an option if the first twin developed an extreme preterm delivery.
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- 2019
17. A case of fetal cytomegalovirus infection in which maternal IgM antibodies were negative
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Masaharu Murata, Minoru Kawakami, Yuka Sato, Yasuyuki Fujita, Nobuhiro Hidaka, Yukiko Kondo, Kiyoko Kato, and Emiko Hara
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0301 basic medicine ,Cytomegalovirus infection ,03 medical and health sciences ,Fetus ,030104 developmental biology ,Igm antibody ,business.industry ,Immunology ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Virology - Published
- 2016
18. Twin pregnancy complicated by total placenta previa in a Fontan-palliated patient: A case report
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Hazumu Nagata, Saki Kido, Aoi Morita, Nobuhiro Hidaka, Kiyoko Kato, and Masahiro Hachisuga
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medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Twin pregnancy ,medicine.medical_treatment ,lcsh:Surgery ,030204 cardiovascular system & hematology ,lcsh:Gynecology and obstetrics ,Article ,Hypoxemia ,03 medical and health sciences ,0302 clinical medicine ,Fontan circulation ,medicine ,Tricuspid atresia ,cardiovascular diseases ,Peripartum Period ,Twin Pregnancy ,lcsh:RG1-991 ,Cardiac catheterization ,Mitral regurgitation ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,lcsh:RD1-811 ,medicine.disease ,Placenta previa ,Surgery ,cardiovascular system ,Gestation ,medicine.symptom ,business - Abstract
We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 weeks' gestation, she had difficulty breathing, cardiomegaly, and worsening mitral regurgitation. At 29 weeks' gestation, an emergency cesarean section was performed, as the patient had massive genital bleeding. A postoperative cardiac catheterization demonstrated a leak from the lateral tunnel to the atrium, which was considered a cause of hypoxemia during the peripartum period. The cardiac workload in a twin pregnancy is greater, which places a Fontan-palliated patient at increased risk. Careful follow-up monitoring with multidisciplinary expertise is recommended., Highlights • A woman with a Fontan circulation and twin pregnancy is at extremely high risk. • The cardiac work load in a twin pregnancy is greater. • Multiple gestation and placenta previa are management challenges for Fontan women. • ART for women with Fontan palliation should be performed with caution.
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- 2018
19. Pregnancy managed by unfractionated heparin after mechanical aortic valve replacement
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Saki Kido, Yuka Sato, Kiyoko Kato, Yasuyuki Fujita, Shotaro Kai, Nobuhiro Hidaka, and Ichiro Sakamoto
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Adult ,Postnatal Care ,medicine.medical_specialty ,Valve thrombosis ,Pregnancy Complications, Cardiovascular ,030204 cardiovascular system & hematology ,Mechanical valve ,Drug Administration Schedule ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Pregnancy ,medicine ,Humans ,Heart Valve Prosthesis Implantation ,030219 obstetrics & reproductive medicine ,business.industry ,Heparin ,Obstetrics and Gynecology ,Mechanical Aortic Valve ,Anticoagulants ,Prenatal Care ,medicine.disease ,Surgery ,Anticoagulant therapy ,Hemorrhagic complication ,Aortic Valve ,Pediatrics, Perinatology and Child Health ,Female ,business ,medicine.drug - Abstract
Pregnancy after mechanical valve replacement involves high risk. Maternal valve thrombosis and hemorrhagic complications are associated with lethal outcomes; therefore, strict anticoagulant therapy is needed. Our patient was 26-year-old primiparous woman. She had undergone aortic valve replacement with a mechanical valve at 4 years of age and had used warfarin 3 mg per day since then. Because of her desire for a baby, she stopped warfarin and conceived spontaneously. She was referred to our hospital. After being informed of her choices, unfractionated heparin (UFH) administration was started. She experienced mild heart failure with sacroiliitis, bacteremia, and hematuria during pregnancy. She delivered her newborn at 37 weeks. Blood loss at delivery was 220 g. Administration of UFH was restarted 4 h after delivery and 3 mg of warfarin was administered from postpartum day (PPD) 6. Hemostatic suturing was required for vaginal bleeding on PPD7. A therapeutic dose of warfarin was achieved on PPD9. Although warfarin use is recommended as anticoagulant therapy for pregnant woman with mechanical valves, the safety and efficacy of UFH have not yet been clarified because of its limited use. More cases are needed to clarify this.
- Published
- 2018
20. Efficacy of an Emergency Cervical Cerclage Using Absorbable Monofilament Sutures
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Yasuyuki Fujita, Kiyoko Kato, Nobuhiro Hidaka, Masahiro Hachisuga, Yuka Sato, Saki Kido, and Takahiro Nakano
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Adult ,medicine.medical_specialty ,Article Subject ,Adolescent ,medicine.medical_treatment ,Gestational Age ,Abortion ,lcsh:Gynecology and obstetrics ,Ultrasonography, Prenatal ,03 medical and health sciences ,Polydioxanone ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Cervical cerclage ,030212 general & internal medicine ,lcsh:RG1-991 ,Cerclage, Cervical ,Retrospective Studies ,Fetus ,030219 obstetrics & reproductive medicine ,Sutures ,business.industry ,Suture Techniques ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,medicine.disease ,Surgery ,medicine.anatomical_structure ,chemistry ,Vagina ,Gestation ,Female ,business ,Research Article - Abstract
Introduction. Although nonabsorbable woven tape has been widely used for cervical cerclage, technical difficulties that can occur with an effaced cervix because of the thickness of the tape, and the risks of local infection are two major concerns. This study investigated perinatal outcomes of pregnancies involving an emergency cervical cerclage using absorbable monofilament polydioxanone sutures, which is a narrow thread and protects against bacterial infection. Materials and Methods. We performed a chart review of patients who underwent emergency McDonald cerclage with polydioxanone sutures at our institution between 2007 and 2015. Gestational age at delivery, duration between cerclage and delivery, and neonatal prognosis were evaluated as primary outcomes. Results. Among the 23 patients (18 singleton and five twin pregnancies) evaluated, ultrasound-indicated (progressive cervical length shortening) were eight (35%) and physical examination-indicated (fetal membranes that prolapsed into the vagina or dilated cervix) were 15 patients (65%). The median gestational age at cerclage was 22+3 weeks (range, 17+5 to 25+3 weeks). Postoperative spontaneous abortion occurred in only one patient. The median gestational age at delivery was 32+5 weeks (range, 20+5 to 40+6 weeks). Extremely preterm delivery before 28 weeks of gestation occurred in four (17%) cases. Full-term delivery was achieved in 10 (42%) cases. The duration between cerclage and delivery ranged from 5 to 136 days (median, 77 days). Except for one case of spontaneous abortion, all newborns survived till hospital discharge. Conclusions. Although our series included some patients at high risk for spontaneous abortion and preterm delivery, satisfactory prolongation and favorable neonatal outcomes were achieved for most patients by using absorbable monofilament sutures, thus suggesting the efficacy of this type of suture for emergency cervical cerclage.
- Published
- 2018
21. External iliac artery thrombosis after common iliac artery balloon occlusion during cesarean hysterectomy for placenta accreta in cervico-isthmic pregnancy
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Arisa Fujiwara, Yukiko Kondo, Nobuhiro Hidaka, Kiyoko Kato, Kotaro Fukushima, and Sayaka Matsueda
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Placenta accreta ,Obstetrics and Gynecology ,Interventional radiology ,Physical examination ,medicine.disease ,Thrombosis ,Common iliac artery ,Surgery ,Dorsalis pedis artery ,medicine.artery ,Medicine ,Radiology ,Thrombus ,business ,Complication - Abstract
Although the role of interventional radiology in the field of obstetrical hemorrhage has been widely reported upon recently, the rate of procedure-related complications has not been fully determined. We present the case of a patient who developed an external iliac artery thrombosis, a rarely reported complication associated with prophylactic common iliac artery balloon occlusion (CIABO). After CIABO, we found that the dorsalis pedis artery of the right foot was weak and the foot was cold, despite the fact that the patient had no complaints. Computed tomography demonstrated a linear thrombus in the right external iliac artery. We managed the patient conservatively using a heparin drip without the need for thromboembolectomy. Our experience suggests that it is important to consider the risk of thrombosis formation after CIABO. Physical examination post-procedure is key to identifying this complication early.
- Published
- 2015
22. Correlation between lung to thorax transverse area ratio and observed/expected lung area to head circumference ratio in fetuses with left-sided diaphragmatic hernia
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Nobuhiro Hidaka, Masaharu Murata, Nobuaki Mitsuda, Keisuke Ishii, and Jun Sasahara
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Thorax ,Embryology ,Fetus ,Lung ,business.industry ,Gestational age ,Congenital diaphragmatic hernia ,General Medicine ,Anatomy ,medicine.disease ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Linear regression ,medicine ,Gestation ,Diaphragmatic hernia ,Nuclear medicine ,business ,Developmental Biology - Abstract
Observed/expected lung area to head circumference ratio (o/e LHR) and lung to thorax transverse area ratio (LTR) are the sonographic indicators of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH), and they are not influenced by gestational age. We aimed to evaluate the relationship between these two parameters in the same subjects with fetal left-sided CDH. Fetuses with left-sided CDH managed between 2005 and 2012 were included. Data of LTR and o/e LHR values measured on the same day prior to 33 weeks' gestation in target fetuses were retrospectively collected. The correlation between the two parameters was estimated using the Spearman's rank-correlation coefficient, and linear regression analysis was used to assess the relationship between them. Data on 61 measurements from 36 CDH fetuses were analyzed to obtain a Spearman's rank-correlation coefficient of 0.74 with the following linear equation: LTR = 0.002 × (o/e LHR) + 0.005. The determination coefficient of this linear equation was sufficiently high at 0.712, and the prediction accuracy obtained with this regression formula was considered satisfactory. A good linear correlation between the LTR and the o/e LHR was obtained, suggesting that we can translate the predictive parameters for each other. This information is expected to be useful to improve our understanding of different investigations focusing on LTR or o/e LHR as a predictor of postnatal outcome in CDH.
- Published
- 2015
23. In Utero Sonographic Findings of Giant Hepatic Hemangioma and Associated Perinatal Complications: A Report of Two Cases
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Yasuo Yumoto, Hiromi Imai, Kiyoko Kato, Saki Kido, Takeshi Murakami, Kotaro Fukushima, and Nobuhiro Hidaka
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Fetus ,medicine.medical_specialty ,lcsh:Medical technology ,prenatal diagnosis ,business.industry ,Ultrasound ,Prenatal diagnosis ,high-output cardiac insufficiency ,Kasabach–Merritt syndrome ,medicine.disease ,Inferior vena cava ,hepatic hemangioma ,Surgery ,lcsh:R855-855.5 ,medicine.vein ,In utero ,Radiology Nuclear Medicine and imaging ,medicine ,Coagulopathy ,Gestation ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Abstract
It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63 mm × 50 mm × 74 mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37 weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach–Merritt syndrome. In Case 2, our ultrasound examination performed at 40 weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99 mm × 54 mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach–Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment.
- Published
- 2015
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24. Congenital left-sided diaphragmatic hernia associated with left pulmonary agenesis: a case report
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Tomoaki Taguchi, Kiyoko Kato, Kotaro Fukushima, Nobuhiro Hidaka, Saki Kido, Takeshi Murakami, and Koji Nagata
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medicine.medical_specialty ,business.industry ,Pulmonary Agenesis ,Medicine ,Radiology, Nuclear Medicine and imaging ,Diaphragmatic hernia ,business ,medicine.disease ,Left sided ,Surgery - Published
- 2015
25. A case of a cervico-isthmic pregnancy without abnormal location of placenta
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Kotaro Fukushima, Yasuo Yumoto, Yasuyuki Fujita, Kiyoko Kato, Nobuhiro Hidaka, and Hiroko Yoshida
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Gynecology ,Embryology ,medicine.medical_specialty ,Ectopic pregnancy ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,medicine.anatomical_structure ,Intrapartum hemorrhage ,Placenta ,embryonic structures ,Pediatrics, Perinatology and Child Health ,medicine ,business ,Cervico isthmic pregnancy ,reproductive and urinary physiology ,Cesarean hysterectomy - Abstract
Cervico-isthmic pregnancies (CIP) are often complicated by massive hemorrhage due to placenta previa and adhesion. Herein, we present a case of CIP without placenta previa, complicated by cervical incompetency. A 39-year-old multiparous woman was diagnosed with CIP at 8 weeks. The placenta was located on the normal site, and no significant ultrasonographic findings were noted after 14 weeks. At 20 weeks, a cervical incompetency was complicated. A healthy infant was delivered by a cesarean hysterectomy at term. Histopathological examination confirmed CIP with placenta increta. In cases with CIP without placenta previa, the diagnosis during early gestation and careful evaluation of uterine cervix is essential to avoid severe complications.
- Published
- 2014
26. Thoracoamniotic shunting for fetal pleural effusion with hydropic change using a double-basket catheter: An insight into the preoperative determinants of shunting efficacy
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Yuka Sato, Masaharu Murata, Nobuhiro Hidaka, Saki Kido, Yasuyuki Fujita, and Kiyoko Kato
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0301 basic medicine ,medicine.medical_specialty ,Catheters ,Pleural effusion ,Hydrops Fetalis ,030105 genetics & heredity ,Ultrasonography, Prenatal ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Hydrops fetalis ,medicine ,Humans ,Survival rate ,Retrospective Studies ,Fetus ,030219 obstetrics & reproductive medicine ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,medicine.disease ,Prognosis ,Surgery ,Shunting ,Pleural Effusion ,Survival Rate ,Catheter ,Treatment Outcome ,Reproductive Medicine ,Hydrothorax ,Female ,business - Abstract
Objectives Although the efficacy of thoracoamniotic shunting (TAS) for fetal hydrothorax is well-recognized, the coexistence of hydrops fetalis is still a clinical challenge. The preoperative determinants of shunting efficacy are not fully understood. In this study, we aimed to investigate the perinatal and postnatal outcomes of hydrops fetalis with pleural effusion treated by TAS using a double-basket catheter, and to discuss the preoperative factors predictive of patients who will benefit from TAS. Study design We conducted a retrospective study in hydropic fetuses with pleural effusion treated by TAS between 2007 and 2015. We extracted information regarding postnatal survival and pretherapeutic sonographic findings, including skin-edema thickness, pleural-effusion pocket size, and Doppler readings. Results Twelve subjects underwent TAS at a median gestational age of 29+5 weeks (range, 25+5–33+2 weeks). Skin edema disappeared or regressed in 7. Three experienced early neonatal death and the other 9 ultimately survived after a live birth at a median gestational age of 33+4 weeks (range, 29+1–38+2 weeks). All surviving children, except for 1, had a pretherapeutic pleural-effusion pocket greater than the precordial-edema thickness. All 3 children that died had precordial-edema thickness equal to or greater than the size of the pleural-effusion pocket. Conclusions We achieved a high survival rate (75%) using the double-basket technique. A greater pretherapeutic width of skin edema compared with the pleural-effusion pocket is possibly suggestive of a treatment-resistant condition and subsequent poor postnatal outcome.
- Published
- 2017
27. Re-evaluation of lung to thorax transverse area ratio immediately before birth in predicting postnatal short-term outcomes of fetuses with isolated left-sided congenital diaphragmatic hernia: A single center analysis
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Saki, Kido, Nobuhiro, Hidaka, Yuka, Sato, Yasuyuki, Fujita, Kina, Miyoshi, Kouji, Nagata, Tomoaki, Taguchi, and Kiyoko, Kato
- Subjects
Adult ,Male ,Risk ,Gestational Age ,Length of Stay ,Thorax ,Prognosis ,Respiration, Artificial ,Survival Analysis ,Ultrasonography, Prenatal ,Oxygen ,Fetus ,Pregnancy ,Prenatal Diagnosis ,Humans ,Female ,Hernias, Diaphragmatic, Congenital ,Lung ,Retrospective Studies - Abstract
We aimed to investigate whether the lung-to-thorax transverse area ratio (LTR) immediately before birth is of diagnostic value for the prediction of postnatal short-term outcomes in cases of isolated left-sided congenital diaphragmatic hernia (CDH). We retrospectively reviewed the cases of fetal isolated left-sided CDH managed at our institution between April 2008 and July 2016. We divided the patients into two groups based on LTR immediately before birth, using a cut-off value of 0.08. We compared the proportions of subjects within the two groups who survived until discharge using Fisher's exact test. Further, using Spearman's rank correlation, we assessed whether LTR was correlated with length of stay, duration of mechanical ventilation, and supplemental oxygen. Twenty-nine subjects were included (five with LTR 0.08, and 24 with LTR ≥ 0.08). The proportion of subjects surviving until discharge was 40% (2/5) for patients with LTR 0.08, as compared with 96% (23/24) for those with LTR ≥ 0.08. LTR measured immediately before birth was negatively correlated with the postnatal length of stay (Spearman's rank correlation coefficient, rs = -0.486), and the duration of supplemental oxygen (rs = -0.537). Further, the duration of mechanical ventilation was longer in patients with a lower LTR value. LTR immediately before birth is useful for the prediction of postnatal short-term outcomes in fetuses with isolated left-sided CDH. In particular, patients with prenatal LTR value less than 0.08 are at increased risk of postnatal death.
- Published
- 2017
28. Spontaneous post-partum rupture of an ovarian artery aneurysm: A case report of successful embolization and a review of the published work
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Nobuhiro Hidaka, Kiyoko Kato, Shoko Wakimoto, and Kotaro Fukushima
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medicine.medical_specialty ,Blood transfusion ,medicine.diagnostic_test ,Vaginal delivery ,business.industry ,medicine.medical_treatment ,Arterial Embolization ,Obstetrics and Gynecology ,Ovarian artery ,medicine.disease ,Surgery ,Aneurysm ,medicine.artery ,Angiography ,medicine ,Embolization ,Radiology ,Peripartum Period ,business - Abstract
It is rare for an ovarian artery aneurysm to rupture during the peripartum period, but the outcome can be catastrophic. Between 1980 and 2013, only nine cases have been reported in the English-language medical published work. We describe a patient with a left ovarian artery aneurysm that ruptured 4 days after an uneventful vaginal delivery. The rupture was immediately identified, using emergent computed tomography and angiography. The hemorrhage was managed using arterial embolization and blood transfusion, allowing for a successful outcome. The possibility of ruptured ovarian artery aneurysm should be considered in the differential diagnosis for women with excessive or localized abdominal pain after childbirth.
- Published
- 2014
29. Successful ex utero intrapartum treatment procedure for prenatally diagnosed severe micrognathia: A case report
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Nobuhiro Hidaka, Yuka Otera, Kotaro Fukushima, Kiyoko Kato, Masanori Suenaga, and Saki Kido
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Fetus ,medicine.medical_specialty ,Polyhydramnios ,Obstetrics ,business.industry ,medicine.medical_treatment ,Obstetrics and Gynecology ,medicine.disease ,Tracheotomy ,Absent stomach ,In utero ,medicine ,Treatment procedure ,business ,Airway ,reproductive and urinary physiology ,Severe micrognathia - Abstract
We present a case of fetal severe micrognathia in which successful airway stabilization was achieved by an ex utero intrapartum treatment procedure. In this case, it was anticipated that the infant would have a vulnerable airway at birth based on in utero sonographic findings, including an extremely hypoplastic jaw, worsening polyhydramnios and absence of stomach visualization. Early sonographic recognition was helpful in preparing the parents and physicians for the possibility of airway emergencies during the perinatal period. When a severely hypoplastic mandible accompanied by polyhydramnios and absent stomach visualization is noted on ultrasound, clinicians should consider the indication for ex utero intrapartum treatment. A multidisciplinary team with technically skilled medical providers should be coordinated to perform the procedure.
- Published
- 2014
30. In utero resolution of microcystic congenital cystic adenomatoid malformation after prenatal betamethasone therapy: A report of three cases and a literature review
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Ryo Yamamoto, Jun Sasahara, Soichiro Nakayama, Akiko Yamashita, Nobuaki Mitsuda, Keisuke Ishii, and Nobuhiro Hidaka
- Subjects
Fetus ,medicine.medical_specialty ,business.industry ,Obstetrics ,Mortality rate ,Gestational age ,medicine.disease ,In utero ,Hydrops fetalis ,Gestation ,Medicine ,Betamethasone ,Radiology, Nuclear Medicine and imaging ,business ,Survival rate ,medicine.drug - Abstract
Fetal congenital cystic adenomatoid malformation (CCAM) can progress to nonimmune hydrops, and the mortality rate of CCAM with hydrops is reported to be nearly 100%. We describe three microcystic CCAM cases in which the fetal condition improved after maternal betamethasone therapy. The median gestational age at steroid administration was 23 5/7 weeks' gestation. The CCAM decreased in size in all cases. Our series showed a 100% hydrops resolution rate (2/2) and a 100% survival rate (3/3). Our experience suggests the efficacy of betamethasone treatment on fetuses with microcystic CCAM who have fluid collection or are at risk of developing hydrops.
- Published
- 2014
31. Perinatal characteristics of fetuses with borderline ventriculomegaly detected by routine ultrasonographic screening of low-risk populations
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Shusaku Hayashi, Akemi Irie, Keisuke Ishii, Nobuaki Mitsuda, Akiko Miyagi, Nobuhiro Hidaka, and Ryoko Kanazawa
- Subjects
Fetus ,Pregnancy ,medicine.medical_specialty ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Japanese population ,medicine.disease ,medicine.anatomical_structure ,Ventricle ,In utero ,Medicine ,Gestation ,Clinical significance ,business ,Ventriculomegaly - Abstract
Aim Fetal borderline ventriculomegaly represents a frequent dilemma in perinatal management. The present study aimed to evaluate the clinical significance of fetal borderline ventriculomegaly in a low-risk Japanese population and to identify the risk factors for associated anomalies. Methods Data of cases of fetal borderline ventriculomegaly detected at 26−28 weeks of gestation by routine ultrasonographic screening of low-risk singleton pregnancies between 2006 and 2012 were retrospectively collected. Ventricular width, in utero progression, associated anomalies, chromosomal abnormalities, and perinatal and postnatal outcomes were assessed. The ventricular width, in utero progression and other perinatal characteristics were compared between the isolated and non-isolated groups. Results Among the total 6020 singleton low-risk pregnancies, we noted that 42 had borderline ventriculomegaly. Six (14%) of these cases had other defects by subsequent detailed examination. Ventriculomegaly resolved or regressed in 35 (83%) and progressed in four (10%) cases, of which three were associated with other anomalies. The median ventricular width was 12.8 mm (range, 10.0–14.7) in the six non-isolated cases and 10.5 mm (range, 10.0–13.3) in the 36 isolated cases; the differences were statistically significant. A ventricular width of 12 mm or more and in utero progression were more frequently observed in non-isolated cases than in isolated cases. Conclusion Fetal borderline ventriculomegaly frequently resolves in utero. A ventricular diameter of more than 12 mm and in utero progression are risk factors for additional anomalies. After the initial diagnosis of borderline ventriculomegaly, the pregnancy should be carefully followed up to determine whether the ventricle size is resolved, remains stable or increases.
- Published
- 2014
32. Prediction of postnatal short-term outcomes in fetuses with isolated congenital left diaphragmatic hernia based on the lung to thorax transverse area ratio immediately before birth
- Author
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Shiyo Ota, Ryo Yamamoto, Hisayoshi Kawahara, Keisuke Ishii, Akio Kubota, Nobuaki Mitsuda, Mitsuhiro Yoneda, Noboru Inamura, Nobuhiro Hidaka, and Jun Sasahara
- Subjects
Thorax ,Mechanical ventilation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Congenital diaphragmatic hernia ,medicine.disease ,Exact test ,Internal medicine ,Positive predicative value ,medicine ,Mann–Whitney U test ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Diaphragmatic hernia ,business ,Survival rate - Abstract
Purpose : In this study, we aimed to determine the clinical value of the lung to thorax transverse area ratio (LTR) as a predictive parameter of short-term postnatal outcomes in fetuses with isolated left-sided congenital diaphragmatic hernia (CDH). Subjects and Methods : Data from cases prenatally diagnosed with isolated left CDH between September 2005 and March 2012 were retrospectively collected from medical records. We divided the patients into two groups according to an LTR cutoff value of 0. 08 immediately before birth. Differences in intact survival rate and duration of mechanical ventilation and supplemental oxygen were analyzed between the two groups using Fisher’s exact test or the MannWhitney U test. The positive and negative predictive values of an LTR value
- Published
- 2014
33. Effects of maternal hyperoxygenation in a case of severe congenital diaphragmatic hernia accompanied by hydrops fetalis
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Nobuaki Mitsuda, Ryo Ishii, Akio Kubota, Nobuhiro Hidaka, Keisuke Ishii, Mayumi Shimada, Futoshi Kayatani, and Noboru Inamura
- Subjects
medicine.medical_specialty ,Fetus ,medicine.diagnostic_test ,Thoracic cavity ,business.industry ,Diaphragmatic breathing ,Congenital diaphragmatic hernia ,medicine.disease ,Inferior vena cava ,Surgery ,medicine.anatomical_structure ,medicine.vein ,Internal medicine ,Hydrops fetalis ,Pediatrics, Perinatology and Child Health ,medicine ,Cardiology ,business ,Fetal echocardiography ,Venous return curve - Abstract
We report a case of severe congenital diaphragmatic hernia accompanied by hydrops fetalis in a fetus conceived by a 33-year-old woman. Fetal magnetic resonance imaging performed at 27 weeks of gestation revealed herniation of the stomach, bowel, and left liver into the thoracic cavity, confirming severe left-sided CDH. Presence of hydrops fetalis at 32 weeks of gestation and its progression over the next 2 weeks was confirmed by fetal echography. Subsequently, fetal echocardiography revealed severe tricuspid regurgitation and reverse flow in the inferior vena cava at 33 weeks, with abnormal left and right ventricular Tei indices, extended left ventricular isovolumetric relaxation time, and increased preload index. Maternal hyperoxygenation (MHO) therapy was initiated at 35 weeks of gestation to increase pulmonary blood flow and promote venous return to the left ventricle. The hydrops was attenuated by MHO for 2 weeks, and fetal echocardiography demonstrated improved cardiac performance. A female infant was born at 37 weeks of gestation and underwent diaphragmatic repair shortly after birth. She survived surgery and was discharged at 4 months of age with no adverse sequelae. This case report suggests that MHO may be a potential therapy for severe congenital diaphragmatic hernia associated with hydrops fetalis.
- Published
- 2014
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34. Results of Fetal Cardiac Ultrasonographic Screening in Our Institute
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Michiko Yamashita, Nobuaki Mitsuda, Noboru Inamura, Futoshi Kayatani, Shusaku Hayashi, Akiko Miyagi, Nobuhiro Hidaka, Akemi Irie, Yukiko Kawazu, and Keisuke Ishii
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Gynecology ,Fetus ,medicine.medical_specialty ,business.industry ,medicine ,business - Published
- 2014
35. Expectant management of pregnancies complicated by fetal growth restriction without any evidence of placental dysfunction at term: Comparison with routine labor induction
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Yuka Sato, Kiyoko Kato, Nobuhiro Hidaka, Yasuyuki Fujita, and Saki Kido
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,Birth weight ,Oligohydramnios ,Gestational Age ,Infant, Newborn, Diseases ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Birth Weight ,Humans ,030212 general & internal medicine ,Labor, Induced ,Fetus ,030219 obstetrics & reproductive medicine ,Fetal Growth Retardation ,Obstetrics ,business.industry ,Cesarean Section ,Neonatal hypoglycemia ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,Extraction, Obstetrical ,medicine.disease ,Hypoglycemia ,Labor induction ,Gestation ,Female ,Hyperbilirubinemia, Neonatal ,business - Abstract
Aim To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. Methods We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries and pregnancies that, at 37 weeks, were complicated by oligohydramnios, decreased fetal cerebroplacental ratio, or pregnancy-related hypertensive disorders. Prior to May 2013, we performed routine labor induction for FGR at term; after that time, we used routine expectant management. The rate of delivery by cesarean or instrumental assist and the rate of neonatal morbidity were compared between the groups. Results The gestational age at delivery and the neonatal birthweight were higher in the expectant management policy group (39+4 vs 38+1 weeks; 2405 vs 2205 g). The cesarean rate (7/77 vs 7/73) and the instrumental delivery rate (5/77 vs 6/73) did not differ. Neonatal hypoglycemia and hyperbilirubinemia were significantly less frequent (10/77 vs 21/73; 7/77 vs 20/73) in the expectant management policy group. Seven patients in the expectant management policy group underwent emergency cesarean delivery; five of these (71%) had required labor induction because of progression to oligohydramnios. Conclusions Expectant management policy for FGR at term can reduce neonatal morbidity without increasing maternal risk or the cesarean rate. Caution should be used, however, during labor if oligohydramnios develops during expectant management.
- Published
- 2016
36. A rare case of fetal meconium peritonitis developing coagulopathy in utero
- Author
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Yusuke Kobayashi, Kiyoko Kato, Takahiro Nakano, and Nobuhiro Hidaka
- Subjects
medicine.medical_specialty ,fetal anemia ,Case Report ,Gastroenterology ,030218 nuclear medicine & medical imaging ,hydrops fetalis ,03 medical and health sciences ,0302 clinical medicine ,meconium peritonitis ,Coagulopathy ,Internal medicine ,Hydrops fetalis ,medicine ,Radiology, Nuclear Medicine and imaging ,Hypoalbuminemia ,Disseminated intravascular coagulation ,fetal ascites ,Fetus ,030219 obstetrics & reproductive medicine ,business.industry ,Meconium peritonitis ,medicine.disease ,In utero ,embryonic structures ,Gestation ,business - Abstract
Hydrops fetalis in association with meconium peritonitis is a rare condition, and the mechanism underlying hydropic changes has not been fully recognized. We present a case of fetal meconium peritonitis with hydrops and coagulopathy. Clinically, the cause of fetal disseminated intravascular coagulation is considered to be a consequence of a systematic inflammatory response based on progressive, but mild fetal anemia without other apparent triggers, thrombocytopenia, elevated white blood cell count and serum C reactive-protein, hypoalbuminemia, and increased vascular permeability. The infant was born at 32 weeks of gestation and survived after postnatal multidisciplinary treatment. Our experience suggests that recognition of this rare condition will enable early diagnosis and better clinical management for fetuses with meconium peritonitis.
- Published
- 2019
37. Fetal cytomegalovirus infection manifesting as transient pancytopenia
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Kotaro Fukushima, Kazuhisa Hachisuga, Ryo Kiyokoba, Kiyoko Kato, Nobuhiro Hidaka, and Yukiyo Sakata
- Subjects
Embryology ,medicine.medical_specialty ,Fetus ,Pediatrics ,business.industry ,Congenital cytomegalovirus infection ,General Medicine ,Neutropenia ,medicine.disease ,Pancytopenia ,Umbilical cord ,Pulmonary hypertension ,Surgery ,medicine.anatomical_structure ,hemic and lymphatic diseases ,Pediatrics, Perinatology and Child Health ,medicine ,Gestation ,Respiratory system ,business ,Developmental Biology - Abstract
We encountered a patient with a fetal cytomegalovirus infection manifesting as pancytopenia and thoracic hypoplasia. The fetal anemia was treated by transfusion via the umbilical cord, and did not progress after 22 weeks' gestation. The neutropenia resolved spontaneously, and only thrombocytopenia was persistent at birth. The severe thoracic hypoplasia led to pulmonary hypertension and required intensive postnatal respiratory management. Our experience suggests that pancytopenia is a possible manifestation in fetuses infected with cytomegalovirus. This may be transient, resolving spontaneously during fetal life; however, caution should be taken with blood counts, particularly platelet counts, after delivery. In addition, clinicians should carefully follow the thoracic volume in cytomegalovirus-infected fetuses and consider the possibility of postnatal severe respiratory insufficiency.
- Published
- 2015
38. Monochorionic Monozygotic Twin Pregnancy Complicated with Twin-Twin Transfusion Syndrome Presenting with an Obvious Lambda Sign in the First Trimester
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Nobuaki Mitsuda, Akiko Yamashita, Shusaku Hayashi, Makoto Takeuchi, Keisuke Ishii, Naoto Yonetani, and Nobuhiro Hidaka
- Subjects
Adult ,Embryology ,medicine.medical_specialty ,Monozygotic twin ,Ultrasonography, Prenatal ,Diagnosis, Differential ,Monozygotic twin pregnancy ,Pregnancy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Twin Twin Transfusion Syndrome ,business.industry ,Obstetrics ,Fetoscopy ,Infant, Newborn ,Obstetrics and Gynecology ,Chorion ,Fetofetal Transfusion ,Twins, Monozygotic ,General Medicine ,medicine.disease ,Pregnancy Trimester, First ,First trimester ,Dichorionic twins ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
In this report, we present a case of twin-twin transfusion syndrome in the presence of the thick dividing wall of each sac in dichorionic twins. The dichorionic diagnosis was based on the presence of the lambda sign at the first-trimester ultrasound evaluation. In addition to fetoscopic and pathological investigation, DNA typing confirmed that the twin set was monochorionic and monozygotic. This case illustrates that although extremely uncommon, the presence of lambda sign does not exclude monochorionic pregnancy.
- Published
- 2015
39. Magnetic resonance fetal right lung volumetry and its efficacy in predicting postnatal short-term outcomes of congenital left-sided diaphragmatic hernia
- Author
-
Keisuke Ishii, Nobuaki Mitsuda, Jun Sasahara, Ryo Yamamoto, Nobuhiro Hidaka, and Yoko Furutake
- Subjects
Fetus ,medicine.medical_specialty ,Lung ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Gestational age ,Congenital diaphragmatic hernia ,Magnetic resonance imaging ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Lung volumetry ,Medicine ,Lung volumes ,Diaphragmatic hernia ,business ,Nuclear medicine - Abstract
Aim We aimed to investigate whether the ratio of magnetic resonance imaging (MRI)-measured right lung volume (RLV) to ultrasonography-estimated bodyweight (RLV/BW) and observed-to-expected (o/e) RLV are of diagnostic value in predicting postnatal outcomes of left congenital diaphragmatic hernia (CDH). Material and Methods We included 32 CDH patients and 34 control subjects. Manually outlined fetal right lung areas on MRI were multiplied by the slice thickness and added to determine the entire volume. The association between RLV and RLV/BW with gestational age in the controls was examined using regression analysis. RLV/BW and o/e RLV were compared between surviving and non-surviving neonates with CDH. Results The expected fetal RLV was derived using the formula RLV (mm3) = 1.717 × (gestational weeks)2.82. In the controls, RLV/BW was nearly constant during the third trimester. The 27 survivors with CDH had a median RLV/BW of 10.7 and a median o/e RLV of 60.0, whereas the five non-surviving neonates had a median RLV/BW of 4.3 and a median o/e RLV of 22.6; the differences were statistically significant. Conclusion Assessment of fetal lungs by MRI volumetry is reliable for clinical use. RLV/BW and o/e RLV are potential predictors of postnatal outcomes of left CDH.
- Published
- 2013
40. Significance of maternal screening for toxoplasmosis, rubella, cytomegalovirus and herpes simplex virus infection in cases of fetal growth restriction
- Author
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Mayumi Shimada, Ryo Yamamoto, Syusaku Hayashi, Keisuke Ishii, Masahiro Nakayama, Nobuhiro Hidaka, and Nobuaki Mitsuda
- Subjects
Adult ,Male ,medicine.medical_specialty ,Amniotic fluid ,Adolescent ,Congenital cytomegalovirus infection ,medicine.disease_cause ,Rubella ,Toxoplasmosis, Congenital ,Serology ,Young Adult ,Pregnancy ,Humans ,Mass Screening ,Medicine ,Serologic Tests ,Mass screening ,Fetal Growth Retardation ,business.industry ,Obstetrics ,Infant, Newborn ,virus diseases ,Obstetrics and Gynecology ,Herpes Simplex ,medicine.disease ,Toxoplasmosis ,Herpes simplex virus ,Cytomegalovirus Infections ,Immunology ,Female ,business - Abstract
Aim The objective of this study was to evaluate the significance of maternal toxoplasmosis, rubella, cytomegalovirus (CMV) and herpes simplex virus (TORCH) screening in cases of fetal growth restriction (FGR). Material and Methods The medical records of women carrying fetuses with FGR who underwent TORCH screening over a 10-year period were retrospectively reviewed for maternal and congenital TORCH infection. Women carrying fetuses with FGR routinely underwent serologic TORCH tests and systematic ultrasound evaluation for congenital abnormalities. If a congenital CMV infection was suspected, amniotic fluid, placenta or neonatal urine was used for CMV DNA detection by polymerase chain reaction. Results In 319 patients, no cases of maternal or congenital infection with toxoplasma, rubella, or herpes simplex virus were found. Conversely, six cases (1.8%) were diagnosed with congenital CMV infection, two of which had no structural abnormalities other than FGR. Conclusions A complete maternal TORCH screening for cases of FGR appears to be unnecessary. Although a maternal CMV test can be considered, the incidence of congenital CMV infection was found to be low in FGR cases.
- Published
- 2012
41. Perinatal outcome of monochorionic diamniotic twin pregnancies managed from early gestation at a single center
- Author
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Haruna Kawaguchi, Nobuaki Mitsuda, Keisuke Ishii, Takeshi Murakoshi, Shusaku Hayashi, Soichiro Nakayama, and Nobuhiro Hidaka
- Subjects
Discordant Twin ,Pregnancy ,medicine.medical_specialty ,business.industry ,Obstetrics ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Gestational age ,Prenatal care ,medicine.disease ,Miscarriage ,medicine ,Gestation ,Twin Anemia-Polycythemia Sequence ,business - Abstract
Aim: The aim of this study was to evaluate the perinatal outcome of monochorionic diamniotic (MD) twin gestations managed from early gestation onward at a single center. Material and Methods: This was a retrospective single-cohort study, spanning 6 years, of 219 MD twin pregnancies who received prenatal care before 14 weeks of gestation and delivered at our center. The subjects were all under the same perinatal management protocol. The incidence of fetal or neonatal death, major neurological complications at 28 days of age, twin–twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence, and discordant birth was evaluated. Laser surgery was offered for TTTS at less than 26 weeks; however, selective feticide was not performed. Results: Pregnancy termination was selected in two cases. Miscarriage occurred in two (1%) of the cases and preterm delivery occurred in 91 (42%). In regard to perinatal outcome at 28 days of age, 195 (89%) women possessed two live infants and 205 (94%) possessed at least one live infant. The overall survival rate was 92% (403/438). The prevalence of TTTS was 17 cases (8%), seven of whom underwent laser surgery. Four cases of twin anemia-polycythemia sequence were diagnosed postnatally (2%); discordant birth was diagnosed in 24 (12%). Major neonatal neurological abnormalities were noted in six cases (2%). Conclusions: The incidence of perinatal complications in 219 sets of MD twins managed from early gestational age to the neonatal period in one perinatal center was demonstrated. The incidence of TTTS was 8%; the survival rate was 89% at 28 days of age.
- Published
- 2012
42. F201 Reduction of Regeneration Temperature by SiC Nano-particles Membrane Filter with Single Pt-nano Particle
- Author
-
Keisuke Nakamura, Masamichi Tanaka, Hiroshi Oki, Ryoko Sanui, Nobuhiro Hidaka, Katsunori Hanamura, and Hiroaki Matsumoto
- Subjects
Reduction (complexity) ,Materials science ,Chemical engineering ,Regeneration (biology) ,Nanoparticle ,Membrane filter - Published
- 2012
43. Grayscale and Doppler sonographic evaluation of response to in utero treatment of hydrops fetalis caused by extralobar pulmonary sequestration
- Author
-
Kiyomi Tsukimori, Nobuhiro Hidaka, Tomoyuki Yoshitomi, Yasuo Yumoto, Kotaro Fukushima, and Norio Wake
- Subjects
Adult ,medicine.medical_specialty ,Pathology ,Thoracoamniotic shunt ,Hydrops Fetalis ,Ultrasonography, Prenatal ,Pulmonary sequestration ,Obstetrics and gynaecology ,Pregnancy ,Hydrops fetalis ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Bronchopulmonary Sequestration ,Doppler study ,Ultrasonography, Doppler, Color ,Fetal Therapies ,Fetus ,business.industry ,medicine.disease ,Pleural Effusion ,In utero ,Hydrothorax ,Drainage ,Female ,Radiology ,business - Abstract
Tomoyuki Yoshitomi, MD, Nobuhiro Hidaka, MD, PhD, Yasuo Yumoto, MD, PhD,Kotaro Fukushima, MD, PhD, Kiyomi Tsukimori, MD, PhD, Norio Wake, MD, PhDDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences,Kyushu University, Fukuoka, JapanReceived 23 October 2010; accepted 16 August 2011ABSTRACT: Pulmonary sequestration is defined asnonfunctional lung tissue that lacks communicationwith the bronchial tree and that is supplied by ananomalous systemic vessel. In comparatively rarecases, pulmonary sequestration may lead to hydro-thorax or hydrops fetalis, which is nearly universallyfatal. In this report, we describe a case of pulmonarysequestration with hydrops fetalis, which wassuccessfully treated by thoracoamniotic shunting. Asonographic Doppler study in this case suggestedthat the underlying mechanism of the hydropicchange in a fetus with extralobar pulmonary seques-tration may have differed from that in fetuses withprimary hydrothorax not associated with a structuralanomaly.
- Published
- 2011
44. Pregnant Women with Complete Atrioventricular Block: Perinatal Risks and Review of Management
- Author
-
Nobuhiro Hidaka, Norio Wake, Yoshihide Chiba, and Kotaro Fukushima
- Subjects
medicine.medical_specialty ,Pregnancy ,business.industry ,General Medicine ,medicine.disease ,Asymptomatic ,Surgery ,Heart failure ,medicine ,In patient ,Permanent pacemaker ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Atrioventricular block - Abstract
We have summarized the care management of pregnant women with complete atrioventricular block (CAVB) by reviewing data from the published literature as well as our own experience in 32 pregnancies. Obstetrical management of women with a permanent pacemaker implanted prior to conception has been sufficiently reported thus far, and the management of such patients is considered to be of low risk. Since CAVB usually does not cause any specific obstetrical problems during pregnancy, prepregnancy prophylactic placement of a permanent pacemaker is not indicated in all asymptomatic patients. However, when asymptomatic women without pacemakers become pregnant, there is a subset that ultimately develops heart failure during pregnancy. Therefore, close surveillance of pregnant patients with CAVB is warranted. The current increase in the use of permanent pacemakers in young women with symptomatic CAVB will certainly limit the need for intrapartum temporary pacing in patients who do not require a pacemaker before pregnancy. In fact, most women with CAVB, who do not require a permanent pacemaker before delivery, can be safely managed during labor without temporary pacing. However, the clinical symptoms and cardiac function of patients should be carefully followed after delivery, even when pregnancy and delivery are uneventful. (PACE 2011; 34:1161–1176)
- Published
- 2011
45. Prenatal Features of Omphalocele and Absent Ductus Venosus
- Author
-
Yasuyuki Fujita, Norio Wake, Yasuo Yumoto, Kotaro Fukushima, Akiko Tanaka, Nobuhiro Hidaka, and Yukiko Kondo
- Subjects
Umbilical Veins ,medicine.medical_specialty ,Polyhydramnios ,Inferior vena cava ,Pericardial effusion ,Ultrasonography, Prenatal ,Vascular anomaly ,Hydrops fetalis ,Internal medicine ,medicine ,Humans ,Abnormalities, Multiple ,Radiology, Nuclear Medicine and imaging ,Fetus ,Omphalocele ,Radiological and Ultrasound Technology ,business.industry ,medicine.disease ,Surgery ,Liver ,medicine.vein ,cardiovascular system ,Cardiology ,business ,Live Birth ,Hernia, Umbilical ,Ductus venosus - Abstract
Absence of the ductus venosus (ADV) is a rare vascular anomaly; however, the advent of color Doppler sonography has facilitated detailed analysis of the fetal venous system, and prenatal diagnosis has been described in the recent literature. 1-16 The ductus venosus is a short vascular channel with a maximum diameter of 2 mm, which connects the intra-abdominal umbilical vein with the inferior vena cava (IVC). Because of its role as a sphincter in the isthmic portion, the ductus venosus regulates the proportion of umbilical vein return, thus protecting the fetus from excessive placental flow. Congenital absence of this narrow vessel leads to lack of this regulation, and subsequent volume overload can place a substantial burden on fetal myocardial performance with the risk of high-output cardiac failure. If the chronic volume overload is severe, cardiomegaly, polyhydramnios, and fluid accumulation such as pleural effusion, ascites, pericardial effusion, and skin edema may occur. Furthermore, ADV is associated with a high incidence of other anomalies. Because of its high incidence of associated anomalies and hydrops fetalis, fetuses with ADV have a high mortality rate. 1-3 The most frequently reported associated anomaly is congenital heart disease. No reports to date have associated ADV with a congenital abdominal wall defect. Here we describe the case of a fetus with omphalocele with extracorporeal liver in association with ADV, which was diagnosed prenatally. The fetus showed polyhydramnios, cardiomegaly, and unilateral pleural effusion as signs of cardiac impairment; however, this condition did not develop throughout the pregnancy, and the neonate survived.
- Published
- 2010
46. Low-Loss Composite Material Containing Fine Zn–Ni–Fe Flakes for High-Frequency Applications
- Author
-
Tadahiro Ohmi, Akinobu Teramoto, Nobuhiro Hidaka, M. Ishitsuka, and Yasushi Shirakata
- Subjects
chemistry.chemical_classification ,Materials science ,Zinc alloys ,Magnetic composite ,chemistry.chemical_element ,Polymer ,Zinc ,Electronic, Optical and Magnetic Materials ,chemistry ,Permeability (electromagnetism) ,Miniaturization ,Helical antenna ,Electrical and Electronic Engineering ,Magnetic leakage ,Composite material - Abstract
A low-loss magnetic composite material consisting of Zn5Ni75Fe20 fine flakes dispersed in a polymer has been developed for miniaturization and performance improvement of high-frequency devices. Fine flakes are produced by a new mixing procedure that prevents cohesion of particles, thereby enhancing the dispersibility of the particles. The complex relative permeabilities of the developed material are mu' = 2.4, mu" = 0.09, and tan deltamu( = mu"/ mu') = 0.04 at 1 GHz. The low-loss properties of the developed magnetic composite material are confirmed by measured and simulated results of the basic characteristics of a small helical antenna loaded with the developed material.
- Published
- 2009
47. Preload Index of the Inferior Vena Cava as a Possible Predictive Marker of Hydropic Changes in Fetuses With Ebstein Anomaly
- Author
-
Yasuyuki Fujita, Kiyomi Tsukimori, Norio Wake, Kotaro Fukushima, Maiko Sugitani, and Nobuhiro Hidaka
- Subjects
Male ,medicine.medical_specialty ,Hydrops Fetalis ,Vena Cava, Inferior ,Sensitivity and Specificity ,Inferior vena cava ,Ultrasonography, Prenatal ,Internal medicine ,Hydrops fetalis ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Fetus ,Predictive marker ,Radiological and Ultrasound Technology ,business.industry ,Reproducibility of Results ,Blood flow ,Prognosis ,medicine.disease ,Ebstein Anomaly ,Preload ,EBSTEIN ANOMALY ,medicine.vein ,cardiovascular system ,Cardiology ,Gestation ,Female ,business - Abstract
Objective. We aimed to investigate whether the preload index of the inferior vena cava (PLI-IVC) is of diagnostic value in predicting hydropic changes in fetuses with Ebstein anomaly. Methods. Five cases of prenatally diagnosed Ebstein anomaly, which were managed at our institution between 1999 and 2008, were retrospectively reviewed. The PLI-IVC was calculated as the ratio between the reversed flow velocity from the right atrium and the forward velocity of the IVC. Results. The PLI-IVC was high in all the cases. In 2 cases, PLI-IVC values tended to increase gradually before hydropic changes were recognized. In the cases without hydrops, PLI-IVC values exhibited a nonlinear trend throughout gestation and did not show any apparent increase. Conclusions. The upward trend of the PLI-IVC rather than the maintenance of a high value can be considered a sign of cardiac failure. The blood flow pattern in the IVC should be carefully monitored in fetuses with Ebstein anomaly for the early identification of fetal impairment.
- Published
- 2009
48. Prenatal diagnosis of trisomy 16 mosaicism manifested as pulmonary artery stenosis
- Author
-
Satoshi O. Suzuki, Nobuhiro Hidaka, Norio Wake, Nari Yamamoto, Satoshi Hojo, and Kiyomi Tsukimori
- Subjects
Adult ,medicine.medical_specialty ,Vascular Malformations ,Trisomy ,Prenatal diagnosis ,Constriction, Pathologic ,Pulmonary Artery ,Ultrasonography, Prenatal ,Umbilical Arteries ,Asian People ,Pregnancy ,medicine ,Humans ,Abnormalities, Multiple ,Radiology, Nuclear Medicine and imaging ,Early onset ,Fetus ,Fetal Growth Retardation ,medicine.diagnostic_test ,Mosaicism ,Single umbilical artery ,business.industry ,Obstetrics ,Pulmonary artery stenosis ,Trisomy 16 ,Abortion, Induced ,medicine.disease ,Pregnancy Trimester, Second ,Amniocentesis ,Female ,Autopsy ,business ,Chromosomes, Human, Pair 16 - Abstract
Trisomy 16 mosaicism detected at midtrimester amniocentesis is rare and indicative of true fetal mosaicism. We report a case of mosaic trisomy 16 diagnosed by amniocentesis in which the sonographic findings included fetal pulmonary artery stenosis, a single umbilical artery, and early onset fetal growth restriction. The pregnancy was legally terminated. A review of previous reports suggests that abnormalities of outlet tracts are rarely encountered in fetuses with trisomy 16 mosaicism revealed via amniocentesis. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009
- Published
- 2009
49. Characteristics and perinatal course of prenatally diagnosed fetal abdominal wall defects managed in a tertiary center in Japan
- Author
-
Norio Wake, Yasuyuki Fujita, Masaharu Murata, Yasuo Yumoto, Kouji Masumoto, Tomoaki Taguchi, Nobuhiro Hidaka, Kiyomi Tsukimori, and Satoshi Hojo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Intrauterine growth restriction ,Prenatal diagnosis ,Ultrasonography, Prenatal ,Abdominal wall ,Pregnancy ,Humans ,Medicine ,reproductive and urinary physiology ,Retrospective Studies ,Gastroschisis ,Fetus ,Omphalocele ,business.industry ,Obstetrics ,Abdominal wall defect ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,medicine.disease ,medicine.anatomical_structure ,embryonic structures ,Female ,business ,Hernia, Umbilical - Abstract
Aims: To identify the clinical characteristics of fetal abdominal wall defects managed at a single institution and to provide information regarding the most likely clinical course of the affected fetuses. Methods: A retrospective review was conducted of 44 fetuses prenatally diagnosed with abdominal wall defects at Kyushu University Hospital between 1990 and 2006. Results: A total of 11 cases of gastroschisis and 33 cases of omphalocele were found. Preterm delivery was observed in eight of 11 fetuses (72.7%) with gastroschisis and in 14 of 27 fetuses (51.9%) with omphalocele who were not artificially aborted. Intrauterine growth restriction (IUGR) was identified in four of 11 fetuses (36.4%) with gastroschisis and in 13 of 27 fetuses (48.1%) with omphalocele who were not aborted artificially. There was a high rate of associated structural anomalies with omphalocele (26/33). Karyotypic abnormalities were observed in eight of 29 tested fetuses with omphalocele (27.6%). The prognosis for a chromosomally normal fetus with omphalocele appeared to largely depend on the associated structural abnormalities and the gestational age at delivery. Despite the frequent presence of IUGR, the outcome of neonates with gastroschisis was good. Conclusions: The possibility of preterm delivery and IUGR should be considered during the management of both omphalocele and gastroschisis. For the management of omphaloceles, chromosomal abnormalities and respiratory insufficiency after birth must also be considered. Timely prenatal diagnosis and the subsequent identification of associated anomalies will improve patient care and will enable clinicians to provide appropriate counseling about the expected course.
- Published
- 2009
50. Transient Urinary Ascites after Vesicocentesis Observed in a Fetus with Megacystis Caused by Posterior Urethral Valve
- Author
-
Nobuhiro Hidaka and Yoshihide Chiba
- Subjects
Adult ,Male ,Posterior urethral valve ,Embryology ,medicine.medical_specialty ,Urinary system ,Urethra ,Pregnancy ,Ascites ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Obstructive uropathy ,Ultrasonography ,Fetus ,business.industry ,Infant, Newborn ,Urinary Bladder Diseases ,Obstetrics and Gynecology ,General Medicine ,Megacystis ,medicine.disease ,Surgery ,Fetal Diseases ,Effusion ,embryonic structures ,Pediatrics, Perinatology and Child Health ,Gestation ,Female ,medicine.symptom ,business - Abstract
Background: Fetal urinary ascites is a condition that is rarely encountered. A review of previous reports suggests that the clinical course of the affected fetuses is highly variable. Methods: In this report, we describe a case in which urinary ascites was observed after vesicocentesis in a fetus with megacystis caused by posterior urethral valve. Results: The urinary ascites was transient, and the fetal outcome was good after a successful vesicoamniotic shunting operation. Conclusions: In utero bladder rupture or injury and the subsequent appearance of urinary ascites may be well tolerated by the fetus. Further, spontaneous resolution can be expected during fetal life; therefore, it appears to be preferable to opt for conservative management in fetuses with urinary ascites. Urinary ascites, particularly after vesicocentesis, should be observed with extreme caution.
- Published
- 2009
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