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ABSTRACT: The purpose of this study was to investigate whether cell-free placental mRNA levels have the potential to predict a placenta previa resulting in hysterectomy.
Twenty-eight singleton pregnant women with placenta previa were classified into the following four groups: 16 women with placenta located at a posterior part of the uterine wall (Group A); 4 each with placenta located at the anterior wall without (Group B) or with (Group C) previous cesarean section; and the other 4 with a history of previous cesarean section and who had the placenta located at an anterior part of uterine wall and underwent a cesarean hysterectomy (Group D). The maternal plasma concentrations of the cell-free placental lactogen (PL) mRNA measured by real-time reverse-transcription polymerase chain reaction (PCR) were converted into multiples of the median (MoM).
The MoM (range) values of cell-free PL mRNA in the control group and Groups A to D were 1.00 (0.39-2.35), 2.04 (0.91-3.93), 2.58 (1.90-3.90), 3.50 (1.20-4.30), and 6.28 (5.24-7.63), respectively. The concentration of cell-free PL mRNA was significantly higher in Group D than in Group A, B, or C (Mann-Whitney's U-test, P < 0.05).
The cell-free PL mRNA concentration in maternal plasma has the potential to predict a subgroup of placenta accreta resulting in hysterectomy.
Prenatal Diagnosis 09/2008; 28(9):805-9. · 2.11 Impact Factor
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ABSTRACT: The aim of the present study was to analyze the antenatal and postnatal outcome of fetal ovarian cysts in relation to their ultrasonographic pattern and size.
Sixteen fetal ovarian cysts were diagnosed in 16 fetuses and followed with serial ultrasonograms in utero and after birth until spontaneous or surgical resolution.
Eleven fetal ovarian cysts were simple cysts at first prenatal scan but 3 of the 11 became complex cysts at last prenatal scan and required postnatal laparoscopic surgery. Seven of the 11 simple cysts (63%) disappeared on follow-up imaging by ultrasonograms or MRI during pregnancy or within 2 months after birth. The rate of spontaneous resolution of simple cysts was higher than that of complex cysts (40.0%). The mean maximum diameter of the ovarian cysts before delivery that were subsequently excised surgically at postnatal period (50+/-13.4 mm) was not different from that of ovarian cysts that resolved spontaneously (42.8+/-12.8 mm, P=0.2918).
In our study, cyst size did not predict the risk of ovarian loss. The opportunity of laparoscopic exploration versus conservative management needs to be investigated because some complex cysts resolved spontaneously in the postnatal period.
Early Human Development 07/2008; 84(6):417-20. · 2.05 Impact Factor
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ABSTRACT: Maternal exposure to polychlorinated biphenyls (PCBs) is associated with increased proportions of spontaneous abortion and stillbirth in animal studies. In Japan in 1968, accidental human exposure to rice oil contaminated with PCBs and other dioxin-related compounds, such as polychlorinated dibenzofurans (PCDFs), led to the development of what was later referred to as Yusho oil disease.
The aim of this study was to investigate the association of maternal PCB and dioxin exposure with adverse pregnancy outcomes in Yusho women.
In 2004, we interviewed 214 Yusho women (512 pregnancies) about their pregnancy outcomes over the past 36 years. Pregnancy outcomes included induced abortion, spontaneous abortion, preterm delivery, and pregnancy loss.
In pregnancy years 1968-1977 (within the first 10 years after exposure), the proportions of induced abortion [odds ratio adjusted for age at delivery (ORadj) = 5.93; 95% confidence interval (CI), 2.21-15.91; two-tailed p < 0.001) and preterm delivery (ORadj = 5.70; 95% CI, 1.17-27.79; p = 0.03) were significantly increased compared with the proportions in pregnancy years 1958-1967 (10 years before the incident). Spontaneous abortion (ORadj = 2.09; 95% CI, 0.84-5.18), and pregnancy loss (ORadj = 2.11; 95% CI, 0.92-4.87) were more frequent (OR = 2.18; 95% CI, 1.02-4.66), but these were not significant (p = 0.11 and p = 0.08, respectively) in pregnancy years 1968-1977. We found no significant increases in the proportions of these adverse pregnancy outcomes in pregnancies occurring during 1978-1987 or 1988-2003 compared with those in pregnancies before 1968.
High levels of PCB/PCDF exposure had some adverse effects on pregnancy outcome in Yusho women.
Environmental Health Perspectives 06/2008; 116(5):626-30. · 7.04 Impact Factor
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ABSTRACT: The results of a chromosomal test by genetic amniocentesis in 58 cases with an increased nuchal translucency (NT; > or =3 mm thickness) revealed 47 cases showing a normal karyotype (81%) and 11 cases (19%) showing an abnormal karyotype. However, the cases of a normal karyotype with increased NT also included those with fetal abnormalities. Among the 49 cases in which NT was observed during the first trimester and then subsequently disappeared, chromosomal abnormalities were observed in five, and fetal abnormalities other than chromosomal abnormalities were observed in two. Meanwhile, all nine cases in which an increased NT remained or in which NT continued to increase in size during the second trimester were diagnosed as having cystic hygroma, and chromosomal abnormalities were found in six cases (67%). It should be noted that the shape of increased NT includes NT with a notch (notched NT) and NT without a notch (smooth NT). Among the 20 cases of notched NT, chromosomal abnormalities were observed in eight (40%), and cystic hygroma was observed in nine (45%). On the other hand, among the 38 cases of smooth NT, chromosomal abnormalities were observed in three (7.9%), but no cystic hygroma was observed. Our results confirm that increased NT does not always indicate a fetal abnormality. Whether NT thickness should be measured as a screening tool for fetal abnormalities remains controversial. However, increased NT may be detected by chance, because a maternal-fetal medical examination using ultrasonography is usually performed in Japan. It is therefore considered to be extremely important to establish a system in which cases are referred to obstetricians who are licensed clinical genetic specialists to obtain appropriate genetic counseling whenever increased NT is clinically observed.
Journal of Human Genetics 05/2008; 53(8):688-93. · 2.57 Impact Factor
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ABSTRACT: This study was conducted to determine whether specific ultrasonographic findings in the prenatal period were associated with survival of children affected with trisomy 18.
Between October 1987 and July 2004, we collected 24 cases with trisomy 18. We investigated the relationship of prenatal ultrasonographic findings, gestational age at delivery, the Apgar score, the mode of delivery, and the neonatal treatment strategies, with survival time.
17 of the 24 neonates died within 1 month after birth (Group 1), 5 died within 12 months (Group 2), and 2 survived for more than 1 year (Group 3). Severe polyhydramnios was more frequent in group 1. In groups 2 and 3, the fluid in fetal stomach was visible in all cases. Severe cardiac anomalies were more frequent in group 1. In groups 2 and 3, all neonates were girl.
Prenatal ultrasonographic findings associated with survival less than 1 month included severe polyhydramnios, absence of the fluid in the stomach, severe cardiac anomaly and male sex.
Prenatal Diagnosis 12/2007; 27(11):1039-44. · 2.11 Impact Factor
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ABSTRACT: Human papilloma virus (HPV) can cause cervical cancer. Risk factors for HPV infection are primarily related to sexual behavior. We determined the prevalence of HPV infection and abnormal cervical cytology in institutionalized women with no previous sexual experience.
The study subjects were 251 patients who sought screening for cervical cancer (45.9+/-9.4 years, mean+/-S.D., range, 14 to 66). They were institutionalized for psychosomatic disorders since childhood, and had no previous sexual experience. In addition to screening for cervical cancer, specimens for HPV testing were collected.
No women who were positive for HPV DNA was detected, though 251 women without sexual experiences were screened by the hybrid capture 2 test including 26 types of HPV-DNA.
Transmission through means other than sexual intercourse may not exist because we could not detect HPV DNA in 251 women with no previous sexual experience.
Gynecologic Oncology 10/2007; 106(3):488-9. · 3.89 Impact Factor
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Clinical Chemistry 07/2007; 53(6):1167-8. · 7.91 Impact Factor
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ABSTRACT: Here we provided the first genetic evidence for an association between the degree of apocrine colostrum secretion and human earwax type. Genotyping at the earwax-type locus, rs17822931 within the ABCC11 gene, revealed that 155 of 225 Japanese women were dry-type and 70 wet-type. Frequency of women without colostrum among dry-type women was significantly higher than that among wet-type women (P<0.0002), and the measurable colostrum volume in dry-type women was significantly smaller than in wet-type women (P=0.0341).
Human Genetics 06/2007; 121(5):631-3. · 5.07 Impact Factor
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ABSTRACT: The study was conducted to determine whether placenta previa increases bleeding during gemeprost-induced termination of second-trimester pregnancy.
We carried out a retrospective study of 158 second-trimester terminations between 12 and 21 weeks' gestation. We compared the intraoperative blood loss among three groups: women without placenta previa undergoing gemeprost termination, women with placenta previa undergoing gemeprost termination and women with placenta previa undergoing dilatation and evacuation (D&E).
Eleven of 158 women (7.0%) had placenta previa; four underwent D&E and seven had gemeprost termination. There was no statistical difference in mean intraoperative blood loss among the three groups, although one of the seven women with placenta previa who underwent gemeprost termination developed serious bleeding requiring blood transfusion.
The use of gemeprost for second-trimester pregnancy termination in women with placenta previa seems to be relatively safe and does not increase intraoperative blood loss in the majority of cases.
Contraception 04/2007; 75(3):238-40. · 2.72 Impact Factor
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Clinical Chemistry 12/2006; 52(11):2121-3. · 7.91 Impact Factor
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Kiyonori Miura,
Koh-Ichiro Yoshiura,
Shoko Miura,
Tatsuro Kondoh,
Naoki Harada,
Kentaro Yamasaki,
Yoko Fujimoto,
Yoko Yamasaki,
Terumi Tanigawa,
Yuriko Kitajima,
Takako Shimada,
Atsushi Yoshida, Daisuke Nakayama,
Masato Tagawa,
Shuichiro Yoshimura,
Joseph Wagstaff,
Yoshihiro Jinno,
Tadayuki Ishimaru,
Norio Niikawa,
Hideaki Masuzaki
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ABSTRACT: The purpose of this study was to know a role of confined placental mosaicism (CPM) in perinatal outcome and postnatal growth and development of infants with intrauterine growth restriction (IUGR). We selected 50 infants with IUGR (<-2.0 SD) from 3,257 deliveries in a regional medical center during the past 10-year period, and carried out cytogenetic and molecular analyses in their placenta and cord blood. Of the 50 infants, 8 had CPM (CPM group) and were composed of five single (CPM2, 7, 13, 22, and 22), one double (CPM7/13), and one quadruple trisomy (CPM2/7/15/20), and one partial monosomy [del(2)(p16)]. The origin of an extra chromosome of trisomy was maternal in six cases of CPM, paternal in one, and undetermined in one. Uniparental disomy in disomic cell lines was ruled out in all these mosaics. We also compared clinical parameters for perinatal outcome between CPM group and infants without evidence of CPM (non-CPM group), such as maternal and gestational age, birth weight, Apgar score, cord blood pH, gender, and uterine artery patterns by Doppler ultrasonography, as well as weight, height, and developmental quotient (DQ) by Denver Developmental Screening Test at age 12 months. Phenotypic abnormalities were noted in two infants with CPM and three infants of non-CPM group: One with CPM22 had ASD and hypospadias, one with CPM7/13 had Russell-Silver syndrome (RSS), and one without CPM had polydactyly, and two without CPM had RSS. All but one infant with CPM are alive at age 12 months. Among the clinical parameters, the detection rate of a notch waveform pattern of the uterine artery was significantly higher in the CPM group (P < 0.05). However, no significant difference was noted in perinatal outcome of pregnancy and in DQ at age 12 months between the two groups. Interestingly, short stature (<-2 SD) at age 12 months was more frequently seen in CPM group (7/8 infants with CPM vs. 8/15 infants without CPM), although no statistically significant difference was obtained. The information obtained will be useful for perinatal care and genetic counseling for infants with IUGR and CPM.
American Journal of Medical Genetics Part A 10/2006; 140A(17):1827-33. · 2.39 Impact Factor
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Shoko Miura,
Kiyonori Miura,
Hideaki Masuzaki,
Noriko Miyake,
Koh-ichiro Yoshiura,
Nadiya Sosonkina,
Naoki Harada,
Osamu Shimokawa, Daisuke Nakayama,
Shuichiro Yoshimura,
Naomichi Matsumoto,
Norio Niikawa,
Tadayuki Ishimaru
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ABSTRACT: Cell-free fetal DNA (cffDNA) in the supernatant of amniotic fluid, which is usually discarded, can be used as a sample for prenatal diagnosis. For rapid prenatal diagnosis of frequent chromosome abnormalities, for example trisomies 13, 18, and 21, and monosomy X, using cffDNA, we have developed a targeted microarray-based comparative genomic hybridization (CGH) panel on which BAC clones from chromosomes 13, 18, 21, X, and Y were spotted. Microarray-CGH analysis was performed for a total of 13 fetuses with congenital anomalies using cffDNA from their uncultured amniotic fluid. Microarray CGH with cffDNA led to successful molecular karyotyping for 12 of 13 fetuses within 5 days. Karyotypes of the 12 fetuses (one case of trisomy 13, two of trisomy 18, two of trisomy 21, one of monosomy X, and six of normal karyotype) were later confirmed by conventional chromosome analysis using cultured amniocytes. The one fetus whose molecular-karyotype was indicated as normal by microarray CGH actually had a balanced translocation, 45,XY,der(14;21)(q10;q10). The results indicated that microarray CGH with cffDNA is a useful rapid prenatal diagnostic method at late gestation for chromosome abnormalities with copy-number changes, especially when combined with conventional karyotyping of cultured amniocytes.
Journal of Human Genetics 02/2006; 51(5):412-7. · 2.57 Impact Factor
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ABSTRACT: PurposeA retrospective analysis of the prognostic significance of the lung-to-head ratio (LHR) on the outcome of fetuses with left-sided
congenital diaphragmatic hernia (CDH).
MethodsA total of 12 fetuses with isolated left CDH without any chromosomal abnormalities were included in this study. Twelve LHR
measurements could retrospectively be calculated from the last available ultrasonographic recordings before birth. The relationship
between the LHR and fetal outcome and gestational age was investigated. The cutoff levels as previously published were applied
to determine their predictive value in this population. The association between other prenatal predictive variables and the
fetal outcome was also determined. Survival was defined as being discharged from the hospital.
ResultsThe overall survival rate was 75%, and a statistically significant difference was observed between the mean LHR of the survivors
and the mean LHR of the nonsurvivors (1.81 vs. 0.43), whereas the mean gestational age of these two groups did not differ.
The LHR was not gestational age dependent with regard to its ability to predict the fetal outcome. The cutoff levels LHR <1,
1-1.4, and >1.4 showed good applicability for predicting fetal outcome within the present study population, with 100% survival
if LHR >1.4 and 75% mortality if LHR <1. The intrathoracic position of the stomach, mediastinal shift, and polyhydramnios
as individual variables and early diagnosis (<25 weeks gestation) all turned out to be poor sonographic predictors of fetal
outcome.
ConclusionThe LHR proved to be a good predictor of fetal outcome, independent of gestational age at the time of measurement. To further
substantiate our observations, a prospective multicenter study is warranted.
Journal of Medical Ultrasonics 08/2005; 32(3):115-119. · 0.33 Impact Factor
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Clinical Chemistry 08/2005; 51(7):1261-3. · 7.91 Impact Factor
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Clinical Chemistry 06/2005; 51(5):923-5. · 7.91 Impact Factor
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Clinical Chemistry 10/2004; 50(9):1709-11. · 7.91 Impact Factor
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ABSTRACT: Pregnancy complicated with myelodysplastic syndrome (MDS) is rare and case management is controversial. We report six cases of MDS that were successfully managed during pregnancy including uneventful transvaginal delivery and satisfactory postpartum clinical prognosis. Two patients with MDS who became pregnant twice had normal uneventful deliveries showing no deterioration of MDS. Our findings suggest that pregnancy should be allowed to full-term in MDS patients, especially those of the refractory anemia type, but strict management should be provided before, during and after pregnancy. Pancytopenia might develop during pregnancy but the likelihood of transformation of MDS to leukemia due to pregnancy is remote.
Leukemia Research 04/2002; 26(3):255-60. · 2.92 Impact Factor
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ABSTRACT: Cerebellar infarction has been described rarely during pregnancy, and there has been no case report of cerebellar infarction with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. A 39-year-old Japanese primipara had postpartum HELLP syndrome soon after cesarean section at term. Several hours later, she developed cerebellar infarction which was fatal. HELLP syndrome may have contributed to the development of cerebellar infarction in the case.
Gynecologic and Obstetric Investigation 02/2002; 53(4):240-2. · 1.28 Impact Factor
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ABSTRACT: OBJJECTIVE: To determine the genotypes of four candidate genes in Japanese women with a history of preeclampsia, and in a control group of parous woman. STUDY DESIGN: Fifty-two pregnant women with a history of preeclampsia in their first pregnancy and 113 normotensive gravid women were studied. All subjects were Japanese women with singleton gestations. Genomic DNA was extracted, and genotypes of angiotensinogen (AGT), methyleneteterahydofolate reductase (MTHFR), factor V Leiden, and prothrombin genes were analyzed. RESULTS: The frequencies of homozygous AGT gene mutation and homozygous MTHFR gene mutation in preeclampsia were significantly higher than that in control. The calculated risk associated with the presence of both mutations did not exceed the risk with polymorphism of each gene. None of the examined cases showed polymorphism of factor V Leiden and prothrombin G20210A genes. CONCLUSION: In Japanese patients with preeclampsia, the angiotensinogen gene and particularly MTHFR gene may play a role in the pathogenesis of preeclampsia
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ABSTRACT: The aim of this study was to test the effects of vitamin E on fetal lung growth in rats with congenital diaphragmatic hernia (CDH). Experimental congenital diaphragmatic hernia (CDH) was induced in rat fetuses by maternal administration of 100 mg nitrofen by gastric gavage on day 9.5 of gestation. Vitamin E was provided at days 16-20 of gestation, at 30 IU/day. Cesarean section was performed at day 21 of gestation. Immunohistochemistry was performed using anti-surfactant protein A (SP-A) and anti-SP-B polyclonal antibodies. RT-PCR evaluated SP-A and SP-B mRNA expressions. The lung weight/body weight ratio in rats with CDH was lower than the control (p<0.01). The number of type II pneumocytes positive for SP-A in untreated CDH rats (n=20) was lower than the control (n=20). The relative amounts of SP-A and SP-B were significantly higher in vitamin Etreated CDH rats (n=20) than untreated CDH rats (p<0.05). Our results suggest that antenatal vitamin E treatment increases the production of surfactant proteins in hypoplastic lung of rats with the CDH
