73 results on '"Aiko Kakigano"'
Search Results
2. A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization
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Shinya Matsuzaki, Misooja Lee, Yoshikazu Nagase, Mariko Jitsumori, Satoko Matsuzaki, Michihide Maeda, Tsuyoshi Takiuchi, Aiko Kakigano, Kazuya Mimura, Yutaka Ueda, Takuji Tomimatsu, Masayuki Endo, and Tadashi Kimura
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Medicine ,Science - Abstract
Abstract This study aimed to review the obstetric complications during subsequent pregnancies after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) by exploring the relationship between prior UAE and obstetric complications through a meta-analysis. We conducted a systematic literature review through March 31, 2021, using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in compliance with the PRISMA guidelines and determined the effect of prior UAE for PPH on the rate of placenta accreta spectrum (PAS), PPH, placenta previa, hysterectomy, fetal growth restriction (FGR), and preterm birth (PTB). Twenty-three retrospective studies (2003–2021) met the inclusion criteria. They included 483 pregnancies with prior UAE and 320,703 pregnancies without prior UAE. The cumulative results of all women with prior UAE indicated that the rates of obstetric complications PAS, hysterectomy, and PPH were 16.3% (34/208), 6.5% (28/432), and 24.0% (115/480), respectively. According to the patient background-matched analysis based on the presence of prior PPH, women with prior UAE were associated with higher rates of PAS (odds ratio [OR] 20.82; 95% confidence interval [CI] 3.27–132.41) and PPH (OR 5.32, 95% CI 1.40–20.16) but not with higher rates of hysterectomy (OR 8.93, 95% CI 0.43–187.06), placenta previa (OR 2.31, 95% CI 0.35–15.22), FGR (OR 7.22, 95% CI 0.28–188.69), or PTB (OR 3.00, 95% CI 0.74–12.14), compared with those who did not undergo prior UAE. Prior UAE for PPH may be a significant risk factor for PAS and PPH during subsequent pregnancies. Therefore, at the time of delivery, clinicians should be more attentive to PAS and PPH when women have undergone prior UAE. Since the number of women included in the patient background-matched study was limited, further investigations are warranted to confirm the results of this study.
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- 2021
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3. Antenatal diagnosis of placenta accreta spectrum after in vitro fertilization-embryo transfer: a systematic review and meta-analysis
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Shinya Matsuzaki, Yoshikazu Nagase, Tsuyoshi Takiuchi, Aiko Kakigano, Kazuya Mimura, Misooja Lee, Satoko Matsuzaki, Yutaka Ueda, Takuji Tomimatsu, Masayuki Endo, and Tadashi Kimura
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Medicine ,Science - Abstract
Abstract Increasing evidence suggests a relationship between in vitro fertilization-embryo transfer (IVF-ET) and placenta accreta spectrum (PAS). Some studies have reported a lower rate of antenatal diagnosis of PAS after IVF-ET compared to PAS with spontaneous conception. This study aimed to review the diagnostic accuracy of PAS after IVF-ET and to explore the relationship between IVF-ET pregnancy and PAS. According to the PRISMA guidelines, a comprehensive systematic review of the literature was conducted through August 31, 2020 to determine the effects of IVF-ET on PAS. In addition, a meta-analysis was conducted to explore the relationship between IVF-ET pregnancy and PAS. Twelve original studies (2011–2020) met the inclusion criteria. Among these, 190,139 IVF-ET pregnancies and 248,534 spontaneous conceptions met the inclusion criteria. In the comparator analysis between PAS after IVF-ET and PAS with spontaneous conception (n = 2), the antenatal diagnosis of PAS after IVF-ET was significantly lower than that of PAS with spontaneous conception (22.2% versus 94.7%, P
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- 2021
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4. Placenta previa with posterior extrauterine adhesion: clinical features and management practice
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Yoshikazu Nagase, Shinya Matsuzaki, Masayuki Endo, Takeya Hara, Aiko Okada, Kazuya Mimura, Kosuke Hiramatsu, Aiko Kakigano, Erika Nakatsuka, Tatsuya Miyake, Tsuyoshi Takiuchi, Yutaka Ueda, Takuji Tomimatsu, and Tadashi Kimura
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Adhesion ,Endometriosis ,Magnetic resonance imaging ,Bakri balloon ,Placenta previa ,Surgery ,RD1-811 - Abstract
Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P
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- 2021
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5. Conservative management for adherent placenta after live birth in angular or interstitial pregnancies: A new entity 'angular placenta attachment'
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Erika Nakatsuka, Kazuya Mimura, Masayuki Endo, Tatsuya Miyake, Aiko Kakigano, Shinya Matsuzaki, Yoko Kawanishi, Takuji Tomimatsu, and Tadashi Kimura
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Conservative management ,Adherent placenta ,Angular pregnancy ,Cornual pregnancy ,Interstitial pregnancy ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective: Angular and interstitial pregnancies have been reported with live births and are often complicated by adherent placentas. Most cases had been treated with hysterectomy or corneal resection. Case report: We successfully treated four patients with conservative management (including one reported previously). Case 1 had a vaginal delivery, but the placenta remained attached. We maintained the patient under observation and delivered the placenta on postpartum day 9. Case 2 underwent a C-section. Uterine artery embolization controlled the hemorrhage without placenta removal. The placenta had disappeared by postpartum day 136. Case 3 underwent a C-section. The right uterine angle, where the placenta was attached, was bulging. We manually removed the placenta. Conclusion: We propose a new entity in angular or interstitial pregnancies called “angular placenta attachment” that could be diagnosed during C-sections or after vaginal delivery without placental separation. Expectant management may be considered for adherent placentas in these cases.
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- 2020
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6. Systematic review on the needle and suture types for uterine compression sutures: a literature review
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Shinya Matsuzaki, Mariko Jitsumori, Takeya Hara, Satoko Matsuzaki, Satoshi Nakagawa, Tatsuya Miyake, Tsuyoshi Takiuchi, Aiko Kakigano, Eiji Kobayashi, Takuji Tomimatsu, and Tadashi Kimura
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Uterine compression suture ,Needle ,Suture size ,Surgery ,RD1-811 - Abstract
Abstract Background This study aimed to identify and review associations between the types of sutures used for uterine compression suture (UCS) and its outcomes in postpartum hemorrhage. Methods An electronic search using PubMed and Scopus databases was performed. We included the English articles reported from January 1, 1997, to May 31, 2017, using search words or terms regarding the types of suture and needle used for UCSs. We only included studies describing the sutures in the systematic review. Results We found 196 studies and included 76 (38.8%) in our analysis. We collected data on maternal outcomes for 924 patients and categorized them. Of the 76 studies, suture sizes 0, 1, and 2 were used in 6, 44, and 32 articles, respectively (some studies used multiple sutures). Of the 45 studies mentioning the needles, curved and straight needles were used in 35 and 10, respectively. The results of our review revealed that about 80% of previous articles used Catgut and Polyglactin 910 sutures. Because no studies that compared the efficacy of different size of sutures were identified, we investigated the differences using the cases reported in previous studies mentioned above. In the first analysis, we compared the uterine preservation rate between size 1 and size 2 sutures. We found no significant difference in uterine preservation rate (92.8%: size 1 vs. 94.2%: size 2, p > 0.05) but found significant difference in transfusion rate (62.4% vs. 79.1%, p
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- 2019
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7. Stinging abdominal pain at 32 gestational weeks with prior classical uterine incision: Careful assessment or emergency cesarean delivery?
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Aiko Kakigano, Shinya Matsuzaki, Yasuto Kinose, Toshihiro Kimura, and Tadashi Kimura
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classical uterine incision ,uterine rupture ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract The risk of uterine rupture in subsequent pregnancy is 1%‐12% in patients with prior classical uterine incision. Management of mild/moderate abdominal pain without an obvious abnormal finding before 36 weeks is challenging owing to fetal immaturity.
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- 2021
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8. New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review
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Shinya Matsuzaki, Masayuki Endo, Takuji Tomimatsu, Satoshi Nakagawa, Satoko Matsuzaki, Tatsuya Miyake, Tsuyoshi Takiuchi, Aiko Kakigano, Kazuya Mimura, Yutaka Ueda, and Tadashi Kimura
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Uterine compression suture ,Needle ,Blunt ,B-Lynch ,Hayman suture ,Surgery ,RD1-811 - Abstract
Abstract Background We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types. Methods A retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS. Results The analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p
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- 2019
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9. Evaluation of leucine-rich alpha-2 glycoprotein as a biomarker of fetal infection.
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Etsuko Kajimoto, Masayuki Endo, Minoru Fujimoto, Shinya Matsuzaki, Makoto Fujii, Kazunobu Yagi, Aiko Kakigano, Kazuya Mimura, Takuji Tomimatsu, Satoshi Serada, Makoto Takeuchi, Kiyoshi Yoshino, Yutaka Ueda, Tadashi Kimura, and Tetsuji Naka
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Medicine ,Science - Abstract
This study aimed to determine the association between umbilical cord leucine-rich alpha-2 glycoprotein (LRG) and fetal infection and investigate the underlying mechanism of LRG elevation in fetuses. We retrospectively reviewed the medical records of patients who delivered at Osaka University Hospital between 2012 and 2017 and selected those with histologically confirmed chorioamnionitis (CAM), which is a common pregnancy complication that may cause neonatal infection. The participants were divided into two groups: CAM with fetal infection (CAM-f[+] group, n = 14) and CAM without fetal infection (CAM-f[-] group, n = 31). Fetal infection was defined by the histological evidence of funisitis. We also selected 50 cases without clinical signs of CAM to serve as the control. LRG concentrations in sera obtained from the umbilical cord were unaffected by gestational age at delivery, neonatal birth weight, nor the presence of noninfectious obstetric complications (all, p > 0.05). Meanwhile, the LRG levels (median, Interquartile range [IQR]) were significantly higher in the CAM-f(+) group (10.37 [5.21-13.7] μg/ml) than in the CAM-f(-) (3.61 [2.71-4.65] μg/ml) or control group (3.39 [2.81-3.93] μg/ml; p < 0.01). The area under the receiver operating characteristic (ROC) curve of LRG for recognizing fetal infection was 0.92 (optimal cutoff, 5.08 μg/ml; sensitivity, 86%; specificity, 88%). In a mouse CAM model established by lipopolysaccharide administration, the fetal LRG protein in sera and LRG mRNA in the liver were significantly higher than those in phosphate-buffered saline (PBS)-administered control mice (p < 0.01). In vitro experiments using a fetal liver-derived cell line (WRL68) showed that the expression of LRG mRNA was significantly increased after interleukin (IL)-6, IL-1β, and tumor necrosis factor- alpha (TNF-α) stimulation (p < 0.01); the induction was considerably stronger following IL-6 and TNF-α stimulation (p < 0.01). In conclusion, LRG is an effective biomarker of fetal infection, and fetal hepatocytes stimulated with inflammatory cytokines may be the primary source of LRG production in utero.
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- 2020
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10. Potency of Tokishakuyakusan in treating preeclampsia: Drug repositioning method by in vitro screening of the Kampo library.
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Kazunobu Yagi, Kazuya Mimura, Takuji Tomimatsu, Tatsuya Matsuyama, Yoko Kawanishi, Aiko Kakigano, Hitomi Nakamura, Masayuki Endo, and Tadashi Kimura
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Medicine ,Science - Abstract
IntroductionPreeclampsia therapy has not been established, except for the termination of pregnancy. The aim of this study was to identify a potential therapeutic agent from traditional Japanese medicine (Kampo) using the drug repositioning method.Materials and methodsWe screened a library of 74 Kampo to identify potential drugs for the treatment of preeclampsia. We investigated the angiogenic effects of these drugs using human umbilical vein endothelial cells (HUVECs). Enzyme-linked immunosorbent assays were performed to measure the levels of placental growth factor (PlGF) in conditioned media treated with 100 μg/mL of each drug. We assessed whether the screened drugs affected cell viability. We performed tube formation assays to evaluate the angiogenic effects of PlGF-inducing drugs. PlGF was measured after administering 10, 50, 100, and 200 μg/mL of the candidate drug in the dose correlation experiment, and at 1, 2, 3, 6, 12, and 24 h in the time course experiment. We also performed tube formation assays with the candidate drug and 100 ng/mL of soluble fms-like tyrosine kinase 1 (sFlt1). PlGF production by the candidate drug was measured in trophoblastic cells (BeWo and HTR-8/SVneo). The Mann-Whitney U test or one-way analyses of variance followed by the Newman-Keuls post-hoc test were performed. P-values < 0.05 were considered significant.ResultsOf the 7 drugs that induced PlGF, Tokishakuyakusan (TS), Shoseiryuto, and Shofusan did not reduce cell viability. TS significantly facilitated tube formation (P = 0.017). TS administration increased PlGF expression in a dose- and time-dependent manner. TS significantly improved tube formation, which was inhibited by sFlt1 (P = 0.033). TS also increased PlGF production in BeWo (P = 0.001) but not HTR-8/SVneo cells (P = 0.33).ConclusionsBy using the drug repositioning method in the in vitro screening of the Kampo library, we identified that TS may have a therapeutic potential for preeclampsia. Its newly found mechanisms involve the increase in PlGF production, and improvement of the antiangiogenic state.
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- 2020
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11. Efficacy of Prophylactic Antibiotics in Bakri Intrauterine Balloon Placement: A Single-Center Retrospective Analysis and Literature Review
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Yoshikazu Nagase, Shinya Matsuzaki, Yoko Kawanishi, Satoshi Nakagawa, Aiko Kakigano, Tsuyoshi Takiuchi, Kazuya Mimura, Takuji Tomimatsu, Masayuki Endo, and Tadashi Kimura
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bakri balloon ,balloon tamponade ,complication ,endometritis ,prophylactic antibiotics ,postpartum hemorrhage ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective Bakri intrauterine balloon (BIUB) placement is an effective treatment for postpartum hemorrhage (PPH). This study aims to evaluate the risk of infection during BIUB placement. Study Design Data for all deliveries (n = 2,144) at our institution between January 2014 and March 2018 were retrospectively reviewed. Patients diagnosed with PPH (n = 758) were included in our analysis, further divided into BIUB (n = 80) and non-BIUB groups (n = 678), and subdivided into vaginal delivery (VD), elective cesarean delivery (CD), and emergency CD groups. Postpartum endometritis rate was compared in each group. A single dose of prophylactic antibiotics was administered for BIUB placement in the VD group. In the CD groups, antibiotics were administered preoperatively once, and no additional antibiotics for BIUB placement were administered. To obtain an antibiotics administration protocol to be applied during BIUB placement, we electronically searched the PubMed and Scopus databases. Results No significant differences were observed in endometritis rates between BIUB and non-BIUB groups of all groups. In the literature review, of 27 suitable publications identified, multiple doses of antibiotics were administered in 17 (62.9%) studies and none investigated the efficacy of a protocol for antibiotic. Conclusion Our protocol might be effective and sufficient in preventing postpartum BIUB placement-related endometritis.
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- 2020
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12. A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage
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Shinya Matsuzaki, Masayuki Endo, Yutaka Ueda, Kazuya Mimura, Aiko Kakigano, Tomomi Egawa-Takata, Keiichi Kumasawa, Kiyoshi Yoshino, and Tadashi Kimura
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Hyponatremia ,Hypopituitarism ,Postpartum hemorrhage ,Sheehan syndrome ,Sheehan’s syndrome ,Subsequent pregnancy ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Sheehan’s syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan’s syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan’s syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan’s syndrome and no reports of successful pregnancies after acute Sheehan’s syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it. An electronic search for acute Sheehan’s syndrome in the literature from January 1990 and May 2014 was performed. Case presentation A 27-year-old woman had massive postpartum hemorrhage (approximately 5000 mL) at her first delivery due to atonic bleeding. She was transfused and treated with uterine embolization, which successfully stopped the bleeding. The postpartum period was uncomplicated through day 7 following the hemorrhage. However, on day 8, the patient had sudden onset of seizures and subsequently became comatose. Laboratory results revealed hypothyroidism, hypoglycemia, hypoprolactinemia, and adrenal insufficiency. Thus, the patient was diagnosed with acute Sheehan’s syndrome. Following treatment with thyroxine and hydrocortisone, her condition improved, and she was discharged on day 24. Her next pregnancy was established 2 years after her first delivery. She required induction of ovulation for the next conception. The pregnancy, delivery, and postpartum period were uneventful. An electronic search of the literature yielded 21 cases of acute Sheehan’s syndrome. Presenting signs varied, including adrenal insufficiency (12 cases), diabetes insipidus (4 cases), hypothyroidism (2 cases), and panhypopituitarism (3 cases), with a median time of presentation after delivery for each of those conditions being 7.9, 4, 18, and 9 days, respectively. Serial changes in magnetic resonance imaging were reported in some cases of acute Sheehan’s syndrome. Conclusion Clinicians should be aware of the risk of acute Sheehan’s syndrome after a massive postpartum hemorrhage in order to diagnose it accurately and treat it promptly.
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- 2017
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13. A rare type of vasa previa
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Takeya Hara, Shinya Matsuzaki, Aiko Kakigano, Kazuya Mimura, Tsuyoshi Takiuchi, and Tadashi Kimura
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rare type ,three‐dimensional image ,vasa previa ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Vasa previa is associated with high fetal morbidity and mortality rates. Although early diagnosis is important, rare types (non‐type I and II) of vasa previa are diagnostically challenging. Our reconstructed images of the rare type of vasa previa are educational and could help clinicians to clinically diagnose this condition.
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- 2019
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14. Hypertensive Disorders of Pregnancy in Relation to Coffee and Tea Consumption: The Japan Environment and Children’s Study
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Yoko Kawanishi, Aiko Kakigano, Takashi Kimura, Satoyo Ikehara, Takuyo Sato, Takuji Tomimatsu, Tadashi Kimura, Hiroyasu Iso, and on behalf of the Japan Environment and Children’s Study Group
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caffeine ,coffee ,hypertensive disorders of pregnancy ,tea ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: The association between coffee/tea intake and hypertensive disorders of pregnancy (HDP) remains unclear. This study aimed to investigate the association of caffeine, coffee, and tea intake during pregnancy with the risk of HDP. Methods: We assessed this association in 85,533 singleton pregnant women with live births in the Japan Environment and Children’s Study, a prospective cohort in Japan that included women from early pregnancy onward. Caffeinated and decaffeinated coffee and tea (green, oolong, and black) consumption during pregnancy was assessed using a validated food frequency questionnaire conducted at mid-pregnancy, and caffeine intake was calculated based on coffee and tea consumption. Multivariable logistic regression was used to assess the association with the risk of HDP. Results: HDP developed in 2222 women (2.6%). Caffeine intake was weakly associated with increased risk of HDP; the multivariable odds ratio of HDP for the highest versus the lowest quartile was 1.26 (95% confidence interval: 1.11, 1.43). Coffee drinkers of two or more cups per day showed a decreased risk compared with non-drinkers (multivariable odds ratio 0.79; 0.62, 0.99) even after adjustment for total caffeine intake. Tea consumption was not associated with the risk of HDP. Conclusions: Our study suggests that higher caffeine intake may increase HDP risk, while coffee drinkers had a lower risk. Further high-quality studies are needed to replicate these findings, and to elucidate if other substances in coffee may be protective against HDP.
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- 2021
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15. Successful management of a pregnant woman of lower‐limb arteriovenous malformation with chronic cardiac failure
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Aiko Kakigano, Shinya Matsuzaki, Kazuya Mimura, Masayuki Endo, Keigo Osuga, and Tadashi Kimura
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Obstetrics and Gynecology - Published
- 2022
16. Two cases of pregnancy after achieving complete remission of chronic active <scp>Epstein–Barr</scp> virus infection
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Nanayo Sasagasako, Akihisa Sawada, Aiko Kakigano, Jun Yoshimatsu, Akihiro Tsuji, and Chizuko Kamiya
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Pediatrics ,medicine.medical_specialty ,Pregnancy ,Ejection fraction ,Chronic Active ,business.industry ,Complete remission ,Obstetrics and Gynecology ,medicine.disease ,medicine.anatomical_structure ,medicine ,Gestation ,Myocardial infarction ,business ,Postpartum period ,Artery - Abstract
Chronic active Epstein-Barr virus (CAEBV) infection characterized by persistent infectious mononucleosis-like symptoms can lead to cardiovascular diseases. We encountered two pregnant women with CAEBV histories complicated with cardiovascular diseases. A 36-year-old woman with a history of myocardial infarction due to CAEBV and coronary artery bypass grafting became pregnant. Her left ventricular ejection fraction (LVEF) decreased, and cesarean section was performed at 36 weeks of gestation. Her LVEF recovered after delivery. A 32-year-old woman with a history of CAEBV and chronic hypertension was diagnosed with mild pulmonary arterial hypertension (PAH) after conception. She strongly desired to continue the pregnancy. She became complicated with severe superimposed preeclampsia at 31 weeks of gestation, and cesarean section was performed. Her PAH did not deteriorate during pregnancy or the postpartum period. Women treated for CAEBV, even with complete remission, require a preconception evaluation focused on the cardiovascular system and careful management of their pregnancy.
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- 2021
17. A systematic review and meta-analysis of obstetric and maternal outcomes after prior uterine artery embolization
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Yoshikazu Nagase, Masayuki Endo, Satoko Matsuzaki, Takuji Tomimatsu, Mariko Jitsumori, Yutaka Ueda, Tadashi Kimura, Tsuyoshi Takiuchi, Michihide Maeda, Kazuya Mimura, Shinya Matsuzaki, Misooja Lee, and Aiko Kakigano
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Risk ,medicine.medical_specialty ,Placenta accreta ,medicine.medical_treatment ,Science ,Placenta Accreta ,Hysterectomy ,Article ,Uterine artery embolization ,Pregnancy ,medicine ,Humans ,Particle Size ,Multidisciplinary ,Fetal Growth Retardation ,business.industry ,Obstetrics ,Postpartum Hemorrhage ,Retrospective cohort study ,Odds ratio ,Uterine Artery Embolization ,medicine.disease ,Confidence interval ,Placenta previa ,Risk factors ,Outcomes research ,Premature Birth ,Medicine ,Female ,business ,Publication Bias - Abstract
This study aimed to review the obstetric complications during subsequent pregnancies after uterine artery embolization (UAE) for postpartum hemorrhage (PPH) by exploring the relationship between prior UAE and obstetric complications through a meta-analysis. We conducted a systematic literature review through March 31, 2021, using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in compliance with the PRISMA guidelines and determined the effect of prior UAE for PPH on the rate of placenta accreta spectrum (PAS), PPH, placenta previa, hysterectomy, fetal growth restriction (FGR), and preterm birth (PTB). Twenty-three retrospective studies (2003–2021) met the inclusion criteria. They included 483 pregnancies with prior UAE and 320,703 pregnancies without prior UAE. The cumulative results of all women with prior UAE indicated that the rates of obstetric complications PAS, hysterectomy, and PPH were 16.3% (34/208), 6.5% (28/432), and 24.0% (115/480), respectively. According to the patient background-matched analysis based on the presence of prior PPH, women with prior UAE were associated with higher rates of PAS (odds ratio [OR] 20.82; 95% confidence interval [CI] 3.27–132.41) and PPH (OR 5.32, 95% CI 1.40–20.16) but not with higher rates of hysterectomy (OR 8.93, 95% CI 0.43–187.06), placenta previa (OR 2.31, 95% CI 0.35–15.22), FGR (OR 7.22, 95% CI 0.28–188.69), or PTB (OR 3.00, 95% CI 0.74–12.14), compared with those who did not undergo prior UAE. Prior UAE for PPH may be a significant risk factor for PAS and PPH during subsequent pregnancies. Therefore, at the time of delivery, clinicians should be more attentive to PAS and PPH when women have undergone prior UAE. Since the number of women included in the patient background-matched study was limited, further investigations are warranted to confirm the results of this study.
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- 2021
18. Safe use of tocilizumab in pregnant women with Takayasu arteritis: three case studies
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Nao Konagai, Chizuko Aoki Kamiya, Atsushi Nakanishi, Naoko Iwanaga, Masami Sawada, Aiko Kakigano, Takeshi Kanagawa, Satoshi Eto, Yoshihiro Nishida, Yoshikazu Nakaoka, and Jun Yoshimatsu
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Rheumatology ,Immunology ,Immunology and Allergy - Published
- 2023
19. Conservative management for adherent placenta after live birth in angular or interstitial pregnancies: A new entity 'angular placenta attachment'
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Takuji Tomimatsu, Erika Nakatsuka, Kazuya Mimura, Shinya Matsuzaki, Masayuki Endo, Tadashi Kimura, Aiko Kakigano, Tatsuya Miyake, and Yoko Kawanishi
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medicine.medical_specialty ,medicine.medical_treatment ,Cornual Pregnancy ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,Uterine artery embolization ,Placenta ,medicine ,Adherent placenta ,reproductive and urinary physiology ,lcsh:RG1-991 ,030219 obstetrics & reproductive medicine ,Hysterectomy ,Obstetrics ,business.industry ,Vaginal delivery ,Obstetrics and Gynecology ,medicine.disease ,Angular Pregnancy ,Angular pregnancy ,medicine.anatomical_structure ,embryonic structures ,Cornual pregnancy ,Conservative management ,Interstitial pregnancy ,Live birth ,business - Abstract
Objective Angular and interstitial pregnancies have been reported with live births and are often complicated by adherent placentas. Most cases had been treated with hysterectomy or corneal resection. Case report We successfully treated four patients with conservative management (including one reported previously). Case 1 had a vaginal delivery, but the placenta remained attached. We maintained the patient under observation and delivered the placenta on postpartum day 9. Case 2 underwent a C-section. Uterine artery embolization controlled the hemorrhage without placenta removal. The placenta had disappeared by postpartum day 136. Case 3 underwent a C-section. The right uterine angle, where the placenta was attached, was bulging. We manually removed the placenta. Conclusion We propose a new entity in angular or interstitial pregnancies called “angular placenta attachment” that could be diagnosed during C-sections or after vaginal delivery without placental separation. Expectant management may be considered for adherent placentas in these cases.
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- 2020
20. Obstetric Outcomes of Pregnancy After Uterine Artery Embolization
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Tadashi Kimura, Tsuyoshi Takiuchi, Takeya Hara, Kazuya Mimura, Masayuki Endo, Takuji Tomimatsu, Mariko Jitsumori, Satoko Matsuzaki, Yutaka Ueda, Tatsuya Miyake, Aiko Kakigano, Eiji Kobayashi, and Shinya Matsuzaki
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Pregnancy ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Hysterectomy ,business.industry ,Obstetrics ,Placenta accreta ,medicine.medical_treatment ,Obstetrics and Gynecology ,Odds ratio ,medicine.disease ,Single Center ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Uterine artery embolization ,Maternity and Midwifery ,Medicine ,030212 general & internal medicine ,business ,Pathological - Abstract
Background Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case-control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE. Methods We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01). Conclusion Our results suggest that previous UAE is a significant risk factor for PAS.
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- 2020
21. Stroke in postpartum reversible cerebral vasoconstriction syndrome
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Hideki Mochizuki, Tatsusada Okuno, Mariko Taniguchi, Takaya Kitano, Makoto Hideshima, Jyunki Jinno, Teruyuki Ishikura, Tsutomu Sasaki, Aiko Kakigano, Shuhei Okazaki, Tomohito Nakano, Kenichi Todo, and Kotaro Watanabe
- Subjects
Nuclear magnetic resonance ,medicine.diagnostic_test ,business.industry ,medicine ,Magnetic resonance imaging ,medicine.disease ,business ,Reversible cerebral vasoconstriction syndrome - Published
- 2020
22. Single versus multiple cervical dilation by osmotic dilator before induction of labor for second‐trimester abortion
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Tsuyoshi Takiuchi, Takuji Tomimatsu, Misooja Lee, Masayuki Endoh, Aiko Kakigano, Kazuya Mimura, Yoko Kawanishi, Shinya Matsuzaki, Tadashi Kimura, and Tatsuya Miyake
- Subjects
Adult ,Osmosis ,medicine.medical_specialty ,Time Factors ,Cervical dilation ,Biocompatible Materials ,Cervix Uteri ,Abortion ,Magnesium Sulfate ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Gemeprost ,Outcome Assessment, Health Care ,medicine ,Humans ,Alprostadil ,Risk factor ,Retrospective Studies ,Abortifacient Agents, Nonsteroidal ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Abortion, Induced ,Induction of labor ,medicine.disease ,Dilatation ,Parity ,Polyvinyl Alcohol ,Pregnancy Trimester, Second ,030220 oncology & carcinogenesis ,Dilator ,Gestation ,Female ,business ,medicine.drug - Abstract
In this study, we aimed to investigate whether there was a significant prognostic difference between single and multiple cervical dilations when inducing second-trimester abortion.We conducted a retrospective review of 238 pregnant women who underwent termination of pregnancy at 12-21 weeks of gestation at Osaka University Hospital in Osaka, Japan, between January 2010 and May 2018. Termination of pregnancy was performed by vaginal administration of 1 mg gemeprost every 3 h for up to five doses per day after uterine cervical dilation using lamicel.The women were categorized into two groups: 191 women had a delivery time of24 h, whereas 47 had delivery times24 h. Contrasting the groups, there were significant differences with regard to numbers of primiparas (88 [46.1%] and 32 [68.1%], respectively) and lamicel exchanges ± SD (1.9 ± 0.67 for24 h and 2.4 ± 0.87 for24 h, respectively). Additionally, we compared the prognosis of primiparas that received just a single lamicel with that of primiparas that had ≥2 exchanged, but no significant differences were noted in the number of patients with a delivery time of24 h and the number of used gemeprost.Primipara is a risk factor for delayed delivery time of induced abortion. However, increasing the number of exchanged lamicel did not significantly reduce the delivery time; therefore, it should be performed as minimally as possible.
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- 2019
23. Antenatal diagnosis of placenta accreta spectrum after in vitro fertilization-embryo transfer: a systematic review and meta-analysis
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Misooja Lee, Takuji Tomimatsu, Satoko Matsuzaki, Yutaka Ueda, Tadashi Kimura, Aiko Kakigano, Tsuyoshi Takiuchi, Masayuki Endo, Shinya Matsuzaki, Yoshikazu Nagase, and Kazuya Mimura
- Subjects
medicine.medical_specialty ,Placenta accreta ,Epidemiology ,medicine.medical_treatment ,Science ,Fertilization in Vitro ,Placenta Accreta ,Article ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Spontaneous conception ,Prenatal Diagnosis ,medicine ,Humans ,reproductive and urinary physiology ,030219 obstetrics & reproductive medicine ,Multidisciplinary ,In vitro fertilisation ,Obstetrics ,business.industry ,Odds ratio ,medicine.disease ,Embryo Transfer ,Confidence interval ,Embryo transfer ,Outcomes research ,030220 oncology & carcinogenesis ,Meta-analysis ,Medicine ,Female ,business - Abstract
Increasing evidence suggests a relationship between in vitro fertilization-embryo transfer (IVF-ET) and placenta accreta spectrum (PAS). Some studies have reported a lower rate of antenatal diagnosis of PAS after IVF-ET compared to PAS with spontaneous conception. This study aimed to review the diagnostic accuracy of PAS after IVF-ET and to explore the relationship between IVF-ET pregnancy and PAS. According to the PRISMA guidelines, a comprehensive systematic review of the literature was conducted through August 31, 2020 to determine the effects of IVF-ET on PAS. In addition, a meta-analysis was conducted to explore the relationship between IVF-ET pregnancy and PAS. Twelve original studies (2011–2020) met the inclusion criteria. Among these, 190,139 IVF-ET pregnancies and 248,534 spontaneous conceptions met the inclusion criteria. In the comparator analysis between PAS after IVF-ET and PAS with spontaneous conception (n = 2), the antenatal diagnosis of PAS after IVF-ET was significantly lower than that of PAS with spontaneous conception (22.2% versus 94.7%, P versus 46.9%, P P P P
- Published
- 2021
24. The association of endometriosis with placenta previa and postpartum hemorrhage: a systematic review and meta-analysis
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Tadashi Kimura, Michihide Maeda, Masayuki Endo, Misooja Lee, Aiko Kakigano, Satoko Matsuzaki, Yoshikazu Nagase, Yutaka Ueda, Shinya Matsuzaki, Kazuya Mimura, Tsuyoshi Takiuchi, and Takuji Tomimatsu
- Subjects
medicine.medical_specialty ,Hysterectomy ,Obstetrics ,business.industry ,Cesarean Section ,medicine.medical_treatment ,Incidence (epidemiology) ,Postpartum Hemorrhage ,Endometriosis ,Placenta Previa ,General Medicine ,Odds ratio ,Cochrane Library ,medicine.disease ,Confidence interval ,Placenta previa ,Pregnancy ,Meta-analysis ,medicine ,Humans ,Female ,business ,reproductive and urinary physiology - Abstract
OBJECTIVE This study aimed to review the effect of endometriosis on the prevalence of placenta previa and postpartum hemorrhage in pregnant patients and the surgical outcomes of pregnant patients with endometriosis developing placenta previa. DATA SOURCES In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the literature was conducted on December 31, 2020, using PubMed, Scopus, and the Cochrane Library. STUDY ELIGIBILITY CRITERIA Comparative studies between pregnant women with and without endometriosis and studies that investigated the surgical outcomes of patients with and without endometriosis developing placenta previa were included. METHODS Here, 2 reviewers independently screened the titles and abstracts, completed data extraction, and assessed the reporting quality using the Risk of Bias in Nonrandomized Studies of Interventions tool. RESULTS Overall, 19 studies (from 2010 to 2020) met the inclusion criteria (98,463 pregnancies with endometriosis and 7,184,313 pregnancies without endometriosis). In the adjusted pooled analysis, endometriosis was associated with a higher rate of placenta previa (adjusted odds ratio, 3.17; 95% confidence interval, 2.58–3.89), whereas the incidence of postpartum hemorrhage was similar between pregnant women with and without endometriosis (adjusted odds ratio, 1.15; 95% confidence interval, 0.99–1.34). When the analysis was restricted to histologically confirmed endometriosis cases, the relationship of endometriosis with placenta previa (adjusted odds ratio, 4.23; 95% confidence interval, 1.74–10.30) and postpartum hemorrhage (adjusted odds ratio, 1.29; 95% confidence interval, 0.50–3.34) was consistent with results from the nonrestricted analysis. There was no study that examined the surgical outcomes of patients with endometriosis developing placenta previa patients. However, there are 3 studies that examined the effect of endometriosis on surgical outcomes during cesarean delivery: 1 study showing that endometriosis was associated with increased intraoperative bleeding during emergent cesarean delivery; the other study showing that endometriosis was associated with an increased incidence of postpartum hemorrhage during cesarean delivery (adjusted odds ratio, 1.1; 95% confidence interval, 1.0–1.2), especially in primiparous women with singleton pregnancies (adjusted odds ratio, 1.7; 95% confidence interval, 1.5–2.0); and another study suggesting a significantly higher rate of hysterectomy (7.1%) and bladder injury (7.1%) in patients with endometriosis than in those without endometriosis. CONCLUSION Endometriosis can potentially be associated with adverse surgical outcomes during cesarean delivery. Although there is a correlation between endometriosis and increased rate of placenta previa, the surgical outcomes of patients with endometriosis developing placenta previa remain understudied.
- Published
- 2021
25. P-079. Significance of hemodynamic indices in prediction of blood pressure elevation in pregnant women with chronic hypertension
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Chizuko Kamiya, Mari Tabuse, Atsushi Nakanishi, Tadasu Shionoiri, Eriko Tsukimura, Jun Yoshimatsu, Naoko Iwanaga, and Aiko Kakigano
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medicine.medical_specialty ,business.industry ,Internal medicine ,Internal Medicine ,Cardiology ,medicine ,Obstetrics and Gynecology ,Hemodynamics ,Chronic hypertension ,business ,Blood pressure elevation - Published
- 2021
26. Placenta previa with posterior extrauterine adhesion: clinical features and management practice
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Kazuya Mimura, Tadashi Kimura, Takeya Hara, Tsuyoshi Takiuchi, Yutaka Ueda, Tatsuya Miyake, Yoshikazu Nagase, Aiko Kakigano, Shinya Matsuzaki, Aiko Okada, Erika Nakatsuka, Kosuke Hiramatsu, Takuji Tomimatsu, and Masayuki Endo
- Subjects
Adult ,medicine.medical_specialty ,Blood Loss, Surgical ,Endometriosis ,lcsh:Surgery ,Placenta previa ,03 medical and health sciences ,Magnetic resonance imaging ,0302 clinical medicine ,Pregnancy ,Placenta ,medicine ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Bakri balloon ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Cesarean Section ,business.industry ,Postpartum Hemorrhage ,Infant, Newborn ,Retrospective cohort study ,lcsh:RD1-811 ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Cohort ,Propensity score matching ,Adhesion ,Premature Birth ,Female ,business ,Research Article - Abstract
Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.
- Published
- 2021
27. Complement activation by an angiogenic imbalance leads to systemic vascular endothelial dysfunction: A new proposal for the pathophysiology of preeclampsia
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Tatsuya Matsuyama, Takuji Tomimatsu, Hitomi Nakamura, Aiko Kakigano, Masayuki Endo, Kazunobu Yagi, Tadashi Kimura, Yoko Kawanishi, and Kazuya Mimura
- Subjects
0301 basic medicine ,Placental growth factor ,Cell Survival ,Placenta ,Immunology ,Primary Cell Culture ,Neovascularization, Physiologic ,Complement Membrane Attack Complex ,Umbilical vein ,Preeclampsia ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,medicine ,Human Umbilical Vein Endothelial Cells ,Immunology and Allergy ,Humans ,Viability assay ,Endothelial dysfunction ,Complement Activation ,Cells, Cultured ,Placenta Growth Factor ,030219 obstetrics & reproductive medicine ,Vascular Endothelial Growth Factor Receptor-1 ,Chemistry ,Obstetrics and Gynecology ,medicine.disease ,Complement system ,Endothelial stem cell ,030104 developmental biology ,Reproductive Medicine ,Factor H ,Case-Control Studies ,Complement Factor H ,Cancer research ,Female ,Endothelium, Vascular - Abstract
The underlying mechanism of preeclampsia by which an angiogenic imbalance results in systemic vascular endothelial dysfunction remains unclear. Complement activation directly induces endothelial dysfunction and is known to be involved in preeclampsia; nevertheless, the association between complement activation and angiogenic imbalance has not been established. This study aimed to evaluate whether angiogenic imbalance affects the expression and secretion of inhibitory complement factor H (CFH) in endothelial cells, resulting in complement activation and systemic vascular endothelial dysfunction. Viability of human umbilical vein endothelial cells (HUVECs) was assessed upon CFH knockdown by targeted-siRNA, and were incubated with complement factors. HUVECs were also treated with placental growth factor (PlGF) and/or soluble fms-like tyrosine kinase 1 (sFlt1), and CFH expression and secretion were measured. These cells were evaluated by cell viability assay and cell surface complement activation was quantified by immunocytochemical assessment of C5b-9 deposition. HUVECs transfected with CFH-siRNA had significantly lower viability than that of control cells. Moreover, the expression and secretion of CFH were significantly increased upon PlGF treatment compared with PlGF + sFlt1 combo. HUVECs treated with PlGF had less C5b-9 deposition and higher viability than HUVECs treated with PlGF + sFlt1. In summary, CFH was found to be essential for endothelial cell survival by inhibiting complement activation. An angiogenic imbalance, including decreased PlGF and increased sFlt1, suppresses CFH expression and secretion, resulting in complement activation on the surface of endothelial cells and systemic vascular endothelial dysfunction.
- Published
- 2020
28. Oxytocin Discontinuation During Induced Labor in Pregnancies With Suspected Fetal Growth Restriction
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Sayuri Iwai, Aiko Kakigano, Shinya Matsuzaki, Kazuya Mimura, Takuji Tomimatsu, Yoko Kawanishi, Tatsuya Miyake, Tadashi Kimura, and Masayuki Endo
- Subjects
medicine.medical_specialty ,Text mining ,Oxytocin ,Obstetrics ,business.industry ,medicine ,Fetal growth ,business ,reproductive and urinary physiology ,Discontinuation ,medicine.drug - Abstract
Objective: Although fetal growth restriction (FGR) is associated with an increased risk of cesarean delivery during induced labor, there is little evidence to guide labor management in such cases. This study aimed to investigate whether discontinuation of oxytocin infusion affects the cesarean delivery rate and the risk of maternal and neonatal complications associated with induced labor in pregnancies with suspected FGR.Methods: This was a retrospective cohort study of singleton pregnancies with vertex presentation and indications for labor induction due to FGR after 34.0 weeks of gestation at our institution from January 2010 to December 2017. Two parallel groups were compared: women who received oxytocin continuously until delivery (continuation group) and women whose oxytocin was discontinued at the beginning of the active phase of labor (discontinuation group).Results: There were 74 women in the continuation group and 51 women in the discontinuation group. The incidence of cesarean deliveries was higher (5.4% vs 2.0%) in the continuation group, but this difference was not statistically significant. However, the incidence of uterine tachysystole (23.0% vs 9.8%) was significantly higher in the continuation group than in the discontinuation group. Differences in labor management did not affect the lengths of the active phase and second stage of labor (mean, 136 ± 122 minutes and 34.2 ± 45 minutes, respectively; 122 ± 104 minutes and 48.8±67 minutes in the continuation group and discontinuation group, respectively). The incidence of postpartum hemorrhage and adverse neonatal outcomes were not significantly different between groups.Conclusions: Oxytocin can be safely discontinued after the active phase of labor in women undergoing labor induction for FGR without an increased risk of cesarean delivery or other unfavorable outcomes. Therefore, this strategy may be considered an alternative to continued oxytocin infusion.
- Published
- 2020
29. Stinging abdominal pain at 32 gestational weeks with prior classical uterine incision: Careful assessment or emergency cesarean delivery?
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Shinya Matsuzaki, Toshihiro Kimura, Yasuto Kinose, Aiko Kakigano, and Tadashi Kimura
- Subjects
classical uterine incision ,medicine.medical_specialty ,Abdominal pain ,Medicine (General) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,Clinical Images ,Gestational Weeks ,Medicine ,Abnormal Finding ,In patient ,Emergency Cesarean Delivery ,uterine rupture ,Fetus ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Uterine rupture ,030220 oncology & carcinogenesis ,Clinical Image ,Subsequent pregnancy ,medicine.symptom ,business - Abstract
The risk of uterine rupture in subsequent pregnancy is 1%‐12% in patients with prior classical uterine incision. Management of mild/moderate abdominal pain without an obvious abnormal finding before 36 weeks is challenging owing to fetal immaturity.
- Published
- 2020
30. Efficacy of Prophylactic Antibiotics in Bakri Intrauterine Balloon Placement: A Single-Center Retrospective Analysis and Literature Review
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Aiko Kakigano, Tadashi Kimura, Yoko Kawanishi, Yoshikazu Nagase, Shinya Matsuzaki, Takuji Tomimatsu, Tsuyoshi Takiuchi, Masayuki Endo, Satoshi Nakagawa, and Kazuya Mimura
- Subjects
medicine.medical_specialty ,endometritis ,medicine.drug_class ,Balloon tamponade ,medicine.medical_treatment ,Antibiotics ,balloon tamponade ,complication ,Single Center ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Elective Cesarean Delivery ,Medicine ,lcsh:RG1-991 ,Bakri balloon ,030219 obstetrics & reproductive medicine ,business.industry ,Vaginal delivery ,Obstetrics and Gynecology ,prophylactic antibiotics ,medicine.disease ,bakri balloon ,postpartum hemorrhage ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Original Article ,Endometritis ,business ,Postpartum Endometritis - Abstract
Objective Bakri intrauterine balloon (BIUB) placement is an effective treatment for postpartum hemorrhage (PPH). This study aims to evaluate the risk of infection during BIUB placement. Study Design Data for all deliveries (n = 2,144) at our institution between January 2014 and March 2018 were retrospectively reviewed. Patients diagnosed with PPH (n = 758) were included in our analysis, further divided into BIUB (n = 80) and non-BIUB groups (n = 678), and subdivided into vaginal delivery (VD), elective cesarean delivery (CD), and emergency CD groups. Postpartum endometritis rate was compared in each group. A single dose of prophylactic antibiotics was administered for BIUB placement in the VD group. In the CD groups, antibiotics were administered preoperatively once, and no additional antibiotics for BIUB placement were administered. To obtain an antibiotics administration protocol to be applied during BIUB placement, we electronically searched the PubMed and Scopus databases. Results No significant differences were observed in endometritis rates between BIUB and non-BIUB groups of all groups. In the literature review, of 27 suitable publications identified, multiple doses of antibiotics were administered in 17 (62.9%) studies and none investigated the efficacy of a protocol for antibiotic. Conclusion Our protocol might be effective and sufficient in preventing postpartum BIUB placement-related endometritis.
- Published
- 2020
31. Systematic review on the needle and suture types for uterine compression sutures: a literature review
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Satoshi Nakagawa, Tadashi Kimura, Aiko Kakigano, Satoko Matsuzaki, Eiji Kobayashi, Tatsuya Miyake, Shinya Matsuzaki, Mariko Jitsumori, Takeya Hara, Tsuyoshi Takiuchi, and Takuji Tomimatsu
- Subjects
Transfusion rate ,medicine.medical_specialty ,lcsh:Surgery ,Perineum ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Pregnancy ,Needle ,medicine ,Humans ,030212 general & internal medicine ,Uterine compression suture ,Polyglactin 910 ,Catgut ,030219 obstetrics & reproductive medicine ,Sutures ,business.industry ,Postpartum Hemorrhage ,Suture Techniques ,Uterus ,Significant difference ,lcsh:RD1-811 ,General Medicine ,Compression (physics) ,Surgery ,Suture size ,Needles ,Female ,Search words ,business ,Research Article - Abstract
BackgroundThis study aimed to identify and review associations between the types of sutures used for uterine compression suture (UCS) and its outcomes in postpartum hemorrhage.MethodsAn electronic search using PubMed and Scopus databases was performed. We included the English articles reported from January 1, 1997, to May 31, 2017, using search words or terms regarding the types of suture and needle used for UCSs. We only included studies describing the sutures in the systematic review.ResultsWe found 196 studies and included 76 (38.8%) in our analysis. We collected data on maternal outcomes for 924 patients and categorized them. Of the 76 studies, suture sizes 0, 1, and 2 were used in 6, 44, and 32 articles, respectively (some studies used multiple sutures). Of the 45 studies mentioning the needles, curved and straight needles were used in 35 and 10, respectively. The results of our review revealed that about 80% of previous articles used Catgut and Polyglactin 910 sutures. Because no studies that compared the efficacy of different size of sutures were identified, we investigated the differences using the cases reported in previous studies mentioned above. In the first analysis, we compared the uterine preservation rate between size 1 and size 2 sutures. We found no significant difference in uterine preservation rate (92.8%: size 1 vs. 94.2%: size 2,p > 0.05) but found significant difference in transfusion rate (62.4% vs. 79.1%,p p = 0.033).ConclusionsOur systematic review showed that approximately 80% of cases were treated by Catgut and Polyglactin 910. Due to the heterogeneity of cases included in this review, it is difficult to estimate which suture is better for UCSs. More robust studies are necessary to enable the identification of the superior suture for performing UCSs.
- Published
- 2019
32. Obstetric outcome in patients with a unicornuate uterus after laparoscopic resection of a rudimentary horn
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Yutaka Ueda, Kiyoshi Yoshino, Shinya Matsuzaki, Tadashi Kimura, Aiko Kakigano, Kazuya Mimura, Masaaki Sawada, Masayuki Endo, Tsuyoshi Takiuchi, and Keiichi Kumasawa
- Subjects
medicine.medical_specialty ,Pregnancy ,Bicornuate uterus ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Vaginal delivery ,Significant difference ,Obstetrics and Gynecology ,Unicornuate uterus ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Small for gestational age ,Laparoscopic resection ,In patient ,business - Abstract
AIM Previous studies have shown adverse obstetric outcomes of the laparoscopic resection of a rudimentary horn. Our study aimed to investigate the obstetric outcome in our institution and to review previous studies. METHODS Using a retrospective analysis, data were reviewed from singleton pregnancies with maternal uterine anomalies at a medical center in Osaka, Japan, between January 2011 and March 2016. The uterine anomaly cases were divided into a 'postlaparoscopic resection of the rudimentary horn' group (study group) and an 'other uterine anomalies' (bicornuate uterus, uterine didelphys and unicornuate uterus) group (control group). Primary outcomes of interest were differences in obstetric outcomes, such as spontaneous preterm birth rate, small for gestational age (SGA) infant rate and hypertensive disorders of pregnancy (HDP) rate between the study and the control group, and the secondary outcome of interest was mode of delivery in the study group. RESULTS Data from 40 deliveries were included in the study (7 deliveries: study group, 33 deliveries: control group). No significant difference was observed between the two groups in terms of either mean gestational weeks at delivery (36.4 weeks vs 37.1 weeks; P = .38), cesarean delivery rate (57.1% vs 57.5%; P = 1.0), SGA infant rate (
- Published
- 2018
33. Current status of non‐invasive prenatal testing in Japan
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Katsuhiko Naruse, Naoki Takeshita, Aiko Kakigano, Akimune Fukushima, Norio Miharu, Hideaki Masuzaki, Naoki Hamajima, Tatsuko Hirose, Yasuhiro Kido, Masanobu Ogawa, Osamu Samura, Reiko Neki, Takeshi Kanagawa, Hideaki Sawai, Yoshimasa Kamei, Takahiro Yamada, Yukiko Katagiri, Keiichi Matsubara, Haruka Hamanoue, Yoko Okamoto, Masaki Ogawa, Nahoko Shirato, Michihiro Kitagawa, Akira Namba, Haruki Nishizawa, Takashi Kaji, Jun Murotsuki, Toshiyuki Fukao, Masaya Hirose, Akihiko Sekizawa, Kazufumi Haino, Tomohiro Tanemoto, Takeshi Nagamatsu, Nobuhiro Suzumori, Aiko Sasaki, Seiji Wada, Shinya Tairaku, Hisashi Masuyama, Kazuhisa Maeda, Kiyonori Miura, Miyuki Nishiyama, Hisao Osada, Maki Hyodo, Shun-ichiro Izumi, Yukie Kawano, Junko Yotsumoto, Yasuyo Kasai, Ayako Sanui, Kiyotake Ichizuka, Haruhiko Sago, Setsuko Nakayama, Takashi Ohba, Hiroaki Nakamura, Fumiki Hirahara, Atsushi Watanabe, and Takashi Okai
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Down syndrome ,Genetic counseling ,Aneuploidy ,Genetic Counseling ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pregnancy ,medicine ,Humans ,Gynecology ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Non invasive ,Obstetrics and Gynecology ,medicine.disease ,Chromosomal diseases ,Test (assessment) ,030104 developmental biology ,Welfare system ,Female ,Trisomy ,business ,Maternal Serum Screening Tests - Abstract
Aim The purpose of this study was to report the 3-year experience of a nationwide demonstration project to introduce non-invasive prenatal testing (NIPT) of maternal plasma for aneuploidy, and review the current status of NIPT in Japan. Methods Tests were conducted to detect aneuploidy in high-risk pregnant women, and adequate genetic counseling was provided. The clinical data, test results, and pregnancy outcomes were recorded. We discuss the problems of NIPT on the basis of published reports and meta-analyses. Results From April 2013 to March 2016, 30 613 tests were conducted at 55 medical sites participating in a multicenter clinical study. Among the 30 613 women tested, 554 were positive (1.81%) and 30 021 were negative (98.1%) for aneuploidy. Of the 289, 128, and 44 women who tested positive for trisomies 21, 18, and 13, respectively, and underwent definitive testing, 279 (96.5%), 106 (82.8%), and 28 (63.6%) were determined to have a true-positive result. For the 13 481 women with negative result and whose progress could be traced, two had a false-negative result (0.02%). The tests were performed on the condition that a standard level of genetic counseling be provided at hospitals. Conclusion Here, we report on the 3-year nationwide experience with NIPT in Japan. It is important to establish a genetic counseling system to enable women to make informed decisions regarding prenatal testing. Moreover, a welfare system is warranted to support women who decide to give birth to and raise children with chromosomal diseases.
- Published
- 2017
34. A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage
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Tadashi Kimura, Shinya Matsuzaki, Keiichi Kumasawa, Tomomi Egawa-Takata, Kiyoshi Yoshino, Yutaka Ueda, Masayuki Endo, Aiko Kakigano, and Kazuya Mimura
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Case Report ,Hypopituitarism ,lcsh:Gynecology and obstetrics ,03 medical and health sciences ,0302 clinical medicine ,Hypothyroidism ,Pregnancy ,Subsequent pregnancy ,medicine ,Adrenal insufficiency ,Humans ,Sheehan’s syndrome ,Sheehan's syndrome ,lcsh:RG1-991 ,Hypoproteinemia ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,Hypoglycemia ,Surgery ,Postpartum hemorrhage ,Sheehan syndrome ,Sheehan Syndrome ,Diabetes insipidus ,Acute Disease ,Female ,Hyponatremia ,business ,Postpartum period ,Adrenal Insufficiency - Abstract
Background Sheehan’s syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan’s syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan’s syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan’s syndrome and no reports of successful pregnancies after acute Sheehan’s syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it. An electronic search for acute Sheehan’s syndrome in the literature from January 1990 and May 2014 was performed. Case presentation A 27-year-old woman had massive postpartum hemorrhage (approximately 5000 mL) at her first delivery due to atonic bleeding. She was transfused and treated with uterine embolization, which successfully stopped the bleeding. The postpartum period was uncomplicated through day 7 following the hemorrhage. However, on day 8, the patient had sudden onset of seizures and subsequently became comatose. Laboratory results revealed hypothyroidism, hypoglycemia, hypoprolactinemia, and adrenal insufficiency. Thus, the patient was diagnosed with acute Sheehan’s syndrome. Following treatment with thyroxine and hydrocortisone, her condition improved, and she was discharged on day 24. Her next pregnancy was established 2 years after her first delivery. She required induction of ovulation for the next conception. The pregnancy, delivery, and postpartum period were uneventful. An electronic search of the literature yielded 21 cases of acute Sheehan’s syndrome. Presenting signs varied, including adrenal insufficiency (12 cases), diabetes insipidus (4 cases), hypothyroidism (2 cases), and panhypopituitarism (3 cases), with a median time of presentation after delivery for each of those conditions being 7.9, 4, 18, and 9 days, respectively. Serial changes in magnetic resonance imaging were reported in some cases of acute Sheehan’s syndrome. Conclusion Clinicians should be aware of the risk of acute Sheehan’s syndrome after a massive postpartum hemorrhage in order to diagnose it accurately and treat it promptly.
- Published
- 2017
35. Pregnancy outcomes in women with different doses of corticosteroid supplementation during labor and delivery
- Author
-
Tadashi Kimura, Masayuki Endo, Shinya Matsuzaki, Aiko Kakigano, Kazuya Mimura, Takao Owa, Keiichi Kumasawa, and Takuji Tomimatsu
- Subjects
medicine.medical_specialty ,medicine.drug_class ,business.industry ,Obstetrics and Gynecology ,Hemodynamics ,030204 cardiovascular system & hematology ,medicine.disease ,University hospital ,Puerperal endometritis ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Adrenal insufficiency ,medicine ,Prednisolone ,Corticosteroid ,030212 general & internal medicine ,business ,Pregnancy outcomes ,Hydrocortisone ,medicine.drug - Abstract
Aim The aim of this study was to report the pregnancy outcomes of women who received different doses of corticosteroid supplementation during labor and delivery. Methods We conducted a retrospective review of 102 pregnant women who received oral corticosteroid therapy, delivered at Osaka University Hospital, and were administered intravenous corticosteroid supplementation during labor and delivery. From January 2008 to May 2012, 47 women were administered a high dose of corticosteroids (HD group). From June 2012 to December 2016, 55 women were given a low dose of corticosteroids (LD group). Results There were no significant differences in the patient characteristics between the two groups. The most frequent disease was systemic lupus erythematosus (30/102; 29.4%). Most women used prednisolone for more than 1 year (91/102; 89.2%) and at a dose of more than 5 mg/day (88/102; 86.3%). The total intravenous dose of hydrocortisone during labor and delivery ± standard deviation was 233.5 ± 129.4 mg (HD group) and 143.4 ± 38.1 mg (LD group), exhibiting a significantly larger dose in the HD group. No patients suffered an adrenal deficiency and there were no significant differences in the hemodynamics. There were three cases of puerperal endometritis, two patients with hyperglycemia, and one wound infection in the HD group, whereas one case of puerperal endometritis in the LD group. There were no significant differences in the neonatal outcomes. Conclusion Pregnancy outcomes did not differ between the high and low doses of corticosteroid supplementation during labor and delivery.
- Published
- 2017
36. Treatment and repair of uterine scar dehiscence during cesarean section
- Author
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Tadashi Iwamiya, Aiko Kakigano, Masaaki Sawada, Ruriko Nakae, Shinya Matsuzaki, Keiichi Kumasawa, Masayuki Endo, Tadashi Kimura, and Yutaka Ueda
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,surgical treatment ,Incidence (epidemiology) ,Case Report ,repair of uterine scar dehiscence ,Case Reports ,General Medicine ,Dehiscence ,uterine scar dehiscence ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,parasitic diseases ,medicine ,population characteristics ,Clinical significance ,030212 general & internal medicine ,Risk factor ,Cesarean section ,Surgical treatment ,business ,Complication ,health care economics and organizations - Abstract
Key Clinical Message The incidence of cesarean section (c‐section) has increased worldwide. Because the major risk factor for uterine scar dehiscence (USD) is a previous c‐section, the rate of this complication has also increased. Its clinical significance and management strategies are unclear. Here, we discuss USD particularly pertaining to its surgical treatment.
- Published
- 2017
37. Horizontal Cervix as a Novel Sign for Predicting Adhesions on the Posterior Extrauterine Wall in Cases of Placenta Previa
- Author
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Yoshikazu Nagase, Tsuyoshi Takiuchi, Aiko Okada, Satoshi Nakagawa, Kazuhide Ogita, Aiko Kakigano, Yutaka Ueda, Shinya Matsuzaki, Takuji Tomimatsu, Kazuya Mimura, Masayuki Endo, Kosuke Hiramatsu, and Tadashi Kimura
- Subjects
endometriosis ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Placenta accreta ,Endometriosis ,Adhesion (medicine) ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Sagittal plane ,Article ,Placenta previa ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine ,magnetic resonance imaging ,Radiology ,business ,Cervix ,Cervical canal ,placenta previa - Abstract
We aimed to identify a magnetic resonance imaging (MRI) feature that can predict posterior extrauterine adhesion (posterior adhesion) antenatally, in patients with placenta previa. We retrospectively reviewed patients with placenta previa who underwent a preoperative MRI examination of placenta accreta spectrum. We categorized the patients into two groups based on whether the cervix was anterior or posterior to a line perpendicular to the anatomical conjugate on the MRI. We projected the perpendicular line toward a straight line through the broad of the back on T2-weighted sagittal MRI images and measured the angle between this line and the line passing through the cervical canal. We analyzed the correlation of the cervical canal angle with the presence of posterior adhesions. Of the 96 patients analyzed, 71 patients had an anteverted cervix and 25 patients had a retroverted cervix. There were 21 posterior adhesions. The adhesion rate was significantly higher in patients with a retroverted cervix than those with an anteverted cervix (8.5% vs. 60%, p = 0.00). The cervical canal angle was &le, 10°, in 25 patients, of these 17 had adhesions (sensitivity, 81.0%, specificity, 89.3%, area under the curve, 0.887, 95% confidence interval, 0.792&ndash, 0.981). This finding, labeled &ldquo, positive horizontal cervix sign,&rdquo, may be a promising indicator of posterior adhesions in patients with placenta previa.
- Published
- 2019
38. Sonographic findings after induced medical abortion at 12-21 weeks of gestation: Retrospective cohort study
- Author
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Tadashi Kimura, Kazuya Mimura, Masayuki Endo, Aiko Kakigano, Takuji Tomimatsu, Shinya Matsuzaki, and Yoko Kawanishi
- Subjects
medicine.medical_specialty ,business.industry ,Obstetrics ,Incidence (epidemiology) ,medicine.medical_treatment ,Uterus ,Obstetrics and Gynecology ,Retrospective cohort study ,Abortion, Induced ,Hypervascularity ,Abortion ,Asymptomatic ,Medical abortion ,Abortion, Spontaneous ,Vascularity ,Reproductive Medicine ,Pregnancy ,medicine ,Gestation ,Humans ,Female ,medicine.symptom ,business ,Retrospective Studies ,Ultrasonography - Abstract
Objective To evaluate sonographic findings and clinical outcomes after induced medical abortions. Study design We reviewed records of women who had induced medical abortions at 12–21 weeks of gestation at the Osaka University Hospital between January 2010 and May 2018. Clinicians evaluated each patient using two-dimensional grayscale transvaginal ultrasonography approximately 1 day, 1 week and 1 month after abortion as a routine care in our hospital. Clinicians employed color Doppler imaging if they detected hyperechoic mass within the endometrial cavity. We evaluated the endometrial vascularity as follows: grade 1, minimal flow; grade 2, moderate flow; and grade 3, highly vascular. We evaluated the incidence of vascularity and assessed the clinical course according to the quantity of vascularity. Clinicians did not provide intervention based on ultrasound findings alone. Results Of 319 patients, 75 (24%) had vascularity at one or more evaluations, including 1% (3/319), 12% (38/319) and 15% (48/319) at 1 day, 1 week and 1 month after abortion, respectively. Of these, 44 had grade 1, 16 had grade 2, and 15 had grade 3. Fifty-four women (72%) with a vascularity had no symptoms. All sonographically-identified vascularity resolved spontaneously regardless of symptoms and quantity of vascularity within 150 days (mean interval 68.6 ± 32.2 days). No patients required transfusion or invasive procedures. Conclusions Vascular endometrial findings were prevalent after induced medical abortions; however, most were asymptomatic, appeared an average of approximately 3 weeks after abortion, and all resolved spontaneously. Implications Although hypervascularity can be found routinely on ultrasonography after induced medical abortions, this finding commonly resolves spontaneously regardless of symptoms and its quantity. Thus, hemodynamically stable patients, even those with sonographic hypervascularity, can be managed expectantly.
- Published
- 2019
39. A rare type of vasa previa
- Author
-
Aiko Kakigano, Tsuyoshi Takiuchi, Takeya Hara, Kazuya Mimura, Shinya Matsuzaki, and Tadashi Kimura
- Subjects
medicine.medical_specialty ,lcsh:R5-920 ,Obstetrics ,business.industry ,urogenital system ,Mortality rate ,lcsh:R ,fungi ,Vasa Previa ,lcsh:Medicine ,vasa previa ,General Medicine ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Clinical Image ,medicine ,cardiovascular system ,rare type ,business ,lcsh:Medicine (General) ,reproductive and urinary physiology ,three‐dimensional image - Abstract
Vasa previa is associated with high fetal morbidity and mortality rates. Although early diagnosis is important, rare types (non‐type I and II) of vasa previa are diagnostically challenging. Our reconstructed images of the rare type of vasa previa are educational and could help clinicians to clinically diagnose this condition.
- Published
- 2019
40. New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review
- Author
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Kazuya Mimura, Masayuki Endo, Satoko Matsuzaki, Satoshi Nakagawa, Yutaka Ueda, Tsuyoshi Takiuchi, Shinya Matsuzaki, Tadashi Kimura, Aiko Kakigano, Takuji Tomimatsu, and Tatsuya Miyake
- Subjects
Adult ,medicine.medical_specialty ,lcsh:Surgery ,Uterine body ,B-Lynch ,03 medical and health sciences ,Polydioxanone ,chemistry.chemical_compound ,0302 clinical medicine ,Blunt ,Suture (anatomy) ,Hayman suture ,medicine ,Retrospective analysis ,Needle ,Humans ,Uterine compression suture ,Retrospective Studies ,Poliglecaprone 25 ,Sutures ,business.industry ,Postpartum Hemorrhage ,Suture Techniques ,Uterus ,Retrospective cohort study ,General Medicine ,lcsh:RD1-811 ,Surgery ,Search terms ,chemistry ,Needles ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business ,Research Article - Abstract
Background We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types. Methods A retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS. Results The analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p
- Published
- 2018
41. Angular placenta attachment: a new entity of adherent placenta after live birth in angular or interstitial pregnancies
- Author
-
Tadashi Kimura, Yoko Kawanishi, Ai Yoshino, Aiko Kakigano, Takuji Tomimatsu, Kazuya Mimura, Masayuki Endo, Shinya Matsuzaki, Erika Nakatsuka, and Tatsuya Miyake
- Subjects
Andrology ,medicine.anatomical_structure ,Reproductive Medicine ,business.industry ,Adherent placenta ,Placenta ,Obstetrics and Gynecology ,Medicine ,Live birth ,business ,Developmental Biology - Published
- 2021
42. Potency of Tokishakuyakusan in treating preeclampsia: Drug repositioning method by in vitro screening of the Kampo library
- Author
-
Yoko Kawanishi, Takuji Tomimatsu, Tadashi Kimura, Kazuya Mimura, Tatsuya Matsuyama, Hitomi Nakamura, Aiko Kakigano, Masayuki Endo, and Kazunobu Yagi
- Subjects
0301 basic medicine ,Placental growth factor ,Physiology ,Maternal Health ,Kampo ,Pharmacology ,Epithelium ,Placental Growth Factor ,Endocrinology ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Animal Cells ,Medicine and Health Sciences ,Medicine ,media_common ,Tube formation ,030219 obstetrics & reproductive medicine ,Multidisciplinary ,Pharmaceutics ,Obstetrics and Gynecology ,Trophoblasts ,Drug repositioning ,Female ,Cellular Types ,Anatomy ,Research Article ,Adult ,Drug ,Cell Survival ,Science ,media_common.quotation_subject ,Library Screening ,Research and Analysis Methods ,Preeclampsia ,03 medical and health sciences ,Complementary and Alternative Medicine ,Drug Therapy ,Growth Factors ,Human Umbilical Vein Endothelial Cells ,Humans ,Potency ,Viability assay ,Molecular Biology Techniques ,Molecular Biology ,Placenta Growth Factor ,Drug Screening ,Molecular Biology Assays and Analysis Techniques ,Endocrine Physiology ,business.industry ,Drug Repositioning ,Biology and Life Sciences ,Endothelial Cells ,Epithelial Cells ,Cell Biology ,Traditional Medicine ,medicine.disease ,Pregnancy Complications ,Biological Tissue ,030104 developmental biology ,Women's Health ,Medicine, Kampo ,business ,Drugs, Chinese Herbal - Abstract
Introduction Preeclampsia therapy has not been established, except for the termination of pregnancy. The aim of this study was to identify a potential therapeutic agent from traditional Japanese medicine (Kampo) using the drug repositioning method. Materials and methods We screened a library of 74 Kampo to identify potential drugs for the treatment of preeclampsia. We investigated the angiogenic effects of these drugs using human umbilical vein endothelial cells (HUVECs). Enzyme-linked immunosorbent assays were performed to measure the levels of placental growth factor (PlGF) in conditioned media treated with 100 μg/mL of each drug. We assessed whether the screened drugs affected cell viability. We performed tube formation assays to evaluate the angiogenic effects of PlGF-inducing drugs. PlGF was measured after administering 10, 50, 100, and 200 μg/mL of the candidate drug in the dose correlation experiment, and at 1, 2, 3, 6, 12, and 24 h in the time course experiment. We also performed tube formation assays with the candidate drug and 100 ng/mL of soluble fms-like tyrosine kinase 1 (sFlt1). PlGF production by the candidate drug was measured in trophoblastic cells (BeWo and HTR-8/SVneo). The Mann-Whitney U test or one-way analyses of variance followed by the Newman-Keuls post-hoc test were performed. P–values < 0.05 were considered significant. Results Of the 7 drugs that induced PlGF, Tokishakuyakusan (TS), Shoseiryuto, and Shofusan did not reduce cell viability. TS significantly facilitated tube formation (P = 0.017). TS administration increased PlGF expression in a dose- and time-dependent manner. TS significantly improved tube formation, which was inhibited by sFlt1 (P = 0.033). TS also increased PlGF production in BeWo (P = 0.001) but not HTR-8/SVneo cells (P = 0.33). Conclusions By using the drug repositioning method in the in vitro screening of the Kampo library, we identified that TS may have a therapeutic potential for preeclampsia. Its newly found mechanisms involve the increase in PlGF production, and improvement of the antiangiogenic state.
- Published
- 2020
43. Evaluation of leucine-rich alpha-2 glycoprotein as a biomarker of fetal infection
- Author
-
Tetsuji Naka, Takuji Tomimatsu, Makoto Fujii, Shinya Matsuzaki, Etsuko Kajimoto, Kazunobu Yagi, Satoshi Serada, Kiyoshi Yoshino, Yutaka Ueda, Tadashi Kimura, Masayuki Endo, Makoto Takeuchi, Kazuya Mimura, Aiko Kakigano, and Minoru Fujimoto
- Subjects
Lipopolysaccharides ,Embryology ,Physiology ,Chorioamnionitis ,Biochemistry ,Umbilical cord ,Umbilical Cord ,Mice ,0302 clinical medicine ,Pregnancy ,Animal Cells ,Immune Physiology ,Funisitis ,Medicine and Health Sciences ,030212 general & internal medicine ,Innate Immune System ,030219 obstetrics & reproductive medicine ,Multidisciplinary ,Gestational age ,Fetal Blood ,C-Reactive Proteins ,Up-Regulation ,medicine.anatomical_structure ,Liver ,In utero ,Cytokines ,Medicine ,Female ,Cellular Types ,Anatomy ,Research Article ,Science ,Immunology ,Research and Analysis Methods ,Cell Line ,Andrology ,03 medical and health sciences ,medicine ,Animals ,Humans ,Immunohistochemistry Techniques ,Glycoproteins ,Retrospective Studies ,Fetuses ,Fetus ,business.industry ,Biology and Life Sciences ,Proteins ,Neonates ,Cell Biology ,Molecular Development ,medicine.disease ,Histochemistry and Cytochemistry Techniques ,Disease Models, Animal ,Neonatal infection ,ROC Curve ,Case-Control Studies ,Immune System ,Hepatocytes ,Immunologic Techniques ,business ,Biomarkers ,Developmental Biology - Abstract
This study aimed to determine the association between umbilical cord leucine-rich alpha-2 glycoprotein (LRG) and fetal infection and investigate the underlying mechanism of LRG elevation in fetuses. We retrospectively reviewed the medical records of patients who delivered at Osaka University Hospital between 2012 and 2017 and selected those with histologically confirmed chorioamnionitis (CAM), which is a common pregnancy complication that may cause neonatal infection. The participants were divided into two groups: CAM with fetal infection (CAM-f[+] group,n =14) and CAM without fetal infection (CAM-f[−] group,n =31). Fetal infection was defined by the histological evidence of funisitis. We also selected 50 cases without clinical signs of CAM to serve as the control. LRG concentrations in sera obtained from the umbilical cord were unaffected by gestational age at delivery, neonatal birth weight, nor the presence of noninfectious obstetric complications (all,p> 0.05). Meanwhile, the LRG levels (median, Interquartile range [IQR]) were significantly higher in the CAM-f(+) group (10.37 [5.21–13.7] μg/ml) than in the CAM-f(−) (3.61 [2.71–4.65] μg/ml) or control group (3.39 [2.81–3.93] μg/ml;p< 0.01). The area under the receiver operating characteristic (ROC) curve of LRG for recognizing fetal infection was 0.92 (optimal cutoff, 5.08 μg/ml; sensitivity, 86%; specificity, 88%). In a mouse CAM model established by lipopolysaccharide administration, the fetal LRG protein in sera andLRGmRNA in the liver were significantly higher than those in phosphate-buffered saline (PBS)-administered control mice (p< 0.01).In vitroexperiments using a fetal liver-derived cell line (WRL68) showed that the expression ofLRGmRNA was significantly increased after interleukin (IL)-6, IL-1β, and tumor necrosis factor- alpha (TNF-α) stimulation (p< 0.01); the induction was considerably stronger following IL-6 and TNF-α stimulation (p< 0.01). In conclusion, LRG is an effective biomarker of fetal infection, and fetal hepatocytes stimulated with inflammatory cytokines may be the primary source of LRG productionin utero.
- Published
- 2020
44. Placenta accreta following hysteroscopic myomectomy
- Author
-
Shinya Matsuzaki, Tadashi Kimura, Satoko Matsuzaki, Yutaka Ueda, Mie Tanaka, Aiko Kakigano, Masayuki Endo, and Keiichi Kumasawa
- Subjects
Gynecology ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Placenta accreta ,First pregnancy ,Case Report ,placenta accreta ,General Medicine ,Case Reports ,Hysteroscopic myomectomy ,medicine.disease ,Placenta previa ,03 medical and health sciences ,0302 clinical medicine ,subsequent pregnancy ,030220 oncology & carcinogenesis ,embryonic structures ,Medicine ,Subsequent pregnancy ,business ,reproductive and urinary physiology - Abstract
Key Clinical Message Hardly any report exists on the influence of hysteroscopic myomectomy on subsequent pregnancy. Placenta accreta is most often associated with placenta previa in women with multiple prior cesarean sections. We report the first case of placenta accreta without placenta previa during the first pregnancy subsequent to hysteroscopic myomectomy.
- Published
- 2016
45. Classification of factors involved in nonreportable results of noninvasive prenatal testing (NIPT) and prediction of success rate of second NIPT
- Author
-
Reiko Neki, Katsuhiko Naruse, Kazutoshi Maeda, Fumiki Hirahara, Akira Namba, Seiji Wada, Shinya Tairaku, Haruka Hamanoue, Jun Murotsuki, Yasuyo Kasai, Hisao Osada, Atsushi Watanabe, Maki Hyodo, Junko Yotsumoto, Masayuki Endo, Rina Akaishi, Naomi Nishikawa, Aiko Kakigano, Keiko Koide, Osamu Samura, Kiyonori Miura, Akimune Fukushima, Masanobu Ogawa, Miyuki Nishiyama, Tatsuko Hirose, Nahoko Shirato, Takeshi Kanagawa, Takashi Kaji, Eri Takeda, Haruhiko Sago, Yoshimasa Kamei, Takashi Ohba, Hiroaki Nakamura, Yukiko Katagiri, Kiyotake Ichizuka, Hisashi Masuyama, Takahiro Yamada, Hideaki Masuzaki, Hideaki Sawai, Michihiro Kitagawa, Aiko Sasaki, Keiichi Matsubara, Nobuhiro Suzumori, Yukie Kawano, Tomohiro Tanemoto, Takahiro Yamashita, Masaki Ogawa, Akihiko Sekizawa, Kazufumi Haino, Yoko Okamoto, Shun-ichiro Izumi, Naoki Takeshita, Naoki Hamajima, Hiroko Kuriki, Takeshi Nagamatsu, and Haruki Nishizawa
- Subjects
0301 basic medicine ,Adult ,medicine.medical_specialty ,Heparin Injection ,Trisomy ,030105 genetics & heredity ,Standard score ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Pregnancy ,Risk Factors ,Prenatal Diagnosis ,Medicine ,Humans ,Genetic Testing ,False Negative Reactions ,Genetics (clinical) ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,High-Throughput Nucleotide Sequencing ,Reproducibility of Results ,Retrospective cohort study ,medicine.disease ,Pregnancy Trimester, First ,Research Design ,Pregnancy Trimester, Second ,Anxiety ,Test performance ,Female ,medicine.symptom ,business ,Blood sampling - Abstract
OBJECTIVE To evaluate the reasons for nonreportable cell-free DNA (cfDNA) results in noninvasive prenatal testing (NIPT), we retrospectively studied maternal characteristics and other details associated with the results. METHODS A multicenter retrospective cohort study in pregnant women undergoing NIPT by massively parallel sequencing (MPS) with failed cfDNA tests was performed between April 2013 and March 2017. The women's data and MPS results were analyzed in terms of maternal characteristics, test performance, fetal fraction (FF), z scores, anticoagulation therapy, and other details of the nonreportable cases. RESULTS Overall, 110 (0.32%) of 34 626 pregnant women had nonreportable cfDNA test results after an initial blood sampling; 22 (20.0%) cases had a low FF (
- Published
- 2018
46. Placental polyp from second-trimester abortion
- Author
-
Tadashi Kimura, Tatsuya Miyake, Kazuya Mimura, Shinya Matsuzaki, Takuji Tomimatsu, Aiko Kakigano, Yoko Kawanishi, and Masayuki Endo
- Subjects
medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,Second trimester abortion ,business ,Developmental Biology ,Placental Polyp - Published
- 2019
47. Efficacy of the dedicated needle for uterine compression suture and Bakri balloon for postpartum hemorrhage with placenta previa
- Author
-
Aiko Kakigano, Nakagawa Satoshi, Masayuki Endo, Kazuya Mimura, Takuji Tomimatsu, Erika Nakatsuka, Tatsuya Miyake, Takeya Hara, Tadashi Kimura, and Shinya Matsuzaki
- Subjects
Bakri balloon ,medicine.medical_specialty ,Reproductive Medicine ,Suture (anatomy) ,business.industry ,medicine ,Obstetrics and Gynecology ,medicine.disease ,Compression (physics) ,business ,Developmental Biology ,Placenta previa ,Surgery - Published
- 2019
48. Gross image of vasa previa restored in the postpartum period
- Author
-
Tadashi Kimura, Aiko Kakigano, Shinya Matsuzaki, Yoshikazu Nagase, Masayuki Endo, and Kazuya Mimura
- Subjects
urogenital system ,business.industry ,fungi ,Vasa Previa ,General Medicine ,Anatomy ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Placenta ,Velamentous cord insertion ,cardiovascular system ,medicine ,business ,reproductive and urinary physiology ,Postpartum period - Abstract
Vasa previa has been represented in many reports only by images of the placenta with velamentous cord insertion after delivery. Our image of the restored membranous vessels with an intact membrane of the uterine lower segment is educational and should help readers to visualize vasa previa.
- Published
- 2018
49. An evident asymmetrical uterus during cesarean delivery
- Author
-
Mariko Jitsumori, Masayuki Endo, Tadashi Kimura, Shinya Matsuzaki, Kazuya Mimura, and Aiko Kakigano
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Placenta accreta ,business.industry ,Obstetrics ,Uterus ,placenta accreta ,General Medicine ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Obstetrics and gynaecology ,Clinical Images ,cesarean delivery ,030220 oncology & carcinogenesis ,Clinical Image ,embryonic structures ,interstitial pregnancy ,medicine ,Interstitial pregnancy ,Cesarean delivery ,business ,reproductive and urinary physiology - Abstract
Key Clinical Message If an obstetrician determines the presence of an asymmetrical uterus during cesarean delivery, the likelihood of an interstitial pregnancy complicated by placenta accreta should be considered. The figures in this article should help advance the current knowledge about a rare type of full‐term interstitial pregnancy complicated by placenta accreta.
- Published
- 2018
50. Arginase controls soluble vascular endothelial growth factor receptor 1 (sFlt1) to maintain pregnancy homeostasis
- Author
-
Keiichi Kumasawa, Masayuki Endo, Kazuya Mimura, Tadashi Kimura, Takuji Tomimatsu, Aiko Kakigano, and Hiroko Tanaka
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Biophysics ,030204 cardiovascular system & hematology ,Transfection ,Biochemistry ,Nitric oxide ,Preeclampsia ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Internal medicine ,medicine ,Human Umbilical Vein Endothelial Cells ,Homeostasis ,Humans ,Secretion ,Tyrosine ,Molecular Biology ,reproductive and urinary physiology ,Vascular Endothelial Growth Factor Receptor-1 ,Arginase ,business.industry ,Pregnancy Outcome ,Cell Biology ,medicine.disease ,Boronic Acids ,Recombinant Proteins ,030104 developmental biology ,Endocrinology ,chemistry ,Solubility ,embryonic structures ,Female ,business ,Cysteine - Abstract
Excessive soluble fms-like tyrosine kinase-1 (sFlt-1) has been strongly implicated in preeclampsia. An increase in the serum sFlt-1 level occurs before the onset of preeclampsia, and the sFlt-1 level is already higher in women who are predisposed to preeclampsia than in normotensive pregnant women. This study aimed to investigate the relation between arginase and sFlt-1 in the plasma of preeclamptic women and normotensive pregnant women. We suggested that a regulatory mechanism exists that suppresses the level of sFlt-1. The relationship between arginase, one of the nitric oxide (NO) modulators, and sFlt-1 was examined. First, the pregnant women were divided into 4 groups: group 1, sFlt-16000 pg/ml and arginase activity110 U/L; group 2, sFlt-1 ≥6000 pg/ml and arginase activity110 U/L; group 3, sFlt-1 ≥6000 pg/ml and arginase activity ≥110 U/L; and group 4, sFlt-16000 pg/ml and arginase activity ≥110 U/L. Groups 2 and 3 comprised preeclamptic women. The preeclampsia/normotensive ratio increased from groups 1 to 3. Under the higher sFlt-1 condition, lower arginase activity was associated with lower occurrence of preeclampsia. Next, in human umbilical endothelial vein cells (HUVECs), a slightly higher concentration of sFlt-1, as in group 2, reduced arginase expression and arginase activity, and S-(2-boronoethyl)-l-cysteine (BEC; arginase inhibitor) impaired sFlt-1 secretion. In contrast, a higher level of sFlt-1 increased arginase expression and activity in HUVECs, as in group 3. These results showed that arginase controlled sFlt-1 elevation to some extent. In conclusion, our results suggest the existence of a mechanism to maintain the level of sFlt-1. Soluble Flt-1 negatively regulated itself against increasing serum sFlt-1 in preeclampsia. Moreover, this study revealed that arginase inhibitors are a potential treatment option for preeclampsia.
- Published
- 2018
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