Rina Akaishi

Hokkaido University Hospital, Sapporo, Hokkaidō, Japan

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Publications (30)48.62 Total impact

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    ABSTRACT: Autophagy is activated by environment unfavorable for survival and requires Atg9a protein. Mice heterozygous for p57Kip2, devoid of the imprinted paternal allele (p57Kip2+/−), are known to develop hypertension during pregnancy. To determine whether fetal Atg9a is involved in the intrauterine survival and growth of fetal mice, this study was performed on Atg9a heterozygous (Atg9a+/−) pregnant mice with and without p57Kip2+/−. The pregnant mice heterozygous for both knockout alleles of Atg9a and p57Kip2 (Atg9a+/−/p57Kip2+/−), but not those heterozygous for Atg9a alone, developed hypertension during pregnancy. Placental expression of Atg9a mRNA was significantly decreased in the Atg9a−/− mice compared to Atg9a+/− or Atg9a+/+ mice. The Atg9a−/− fetal mice exhibited significantly retarded growth and were more likely to die in utero compared to Atg9a+/+ and Atg9a+/− fetal mice. Growth retardation was observed in the presence of maternal hypertension in Atg9a−/− fetal mice. These results suggest that Atg9a−/− fetal mice from pregnant dams heterozygous for both knockout alleles of Atg9a and p57Kip2 are more susceptible to hypertensive stress than fetuses with intact autophagic machinery.
    Reproductive biology 06/2015; 27. DOI:10.1016/j.repbio.2015.05.001 · 1.05 Impact Factor
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    ABSTRACT: Hypofibrinogenemia is rare in pulmonary thromboembolism. A pregnant woman with dyspnea, abdominal pain, restlessness, agitation and protein S deficiency exhibited normal blood oxygenation and high D‐dimer (370 μg/mL) and undetectable fibrinogen levels in the blood. The pathogenesis responsible for present findings may have some features similar to amniotic fluid embolism. Hypofibrinogenemia is rare in pulmonary thromboembolism. A pregnant woman at gestational week 30‐5/7 with dyspnea, abdominal pain, restlessness, agitation and protein S deficiency exhibited normal blood oxygenation and high D‐dimer (370 μg/mL) and undetectable fibrinogen levels in the blood. The pathogenesis responsible for present findings may have some features similar to amniotic fluid embolism.
    04/2015; 3(4). DOI:10.1002/ccr3.200
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    ABSTRACT: This literature review was conducted to provide better counsel to pregnant women who erroneously took angiotensin receptor blockers (ARBs) during the second and/or third trimesters regarding infant outcomes. Information was available on 83 fetuses in 34 literature reports, including one that we encountered recently. Fourteen pregnancies were terminated, and six were unknown regarding status of amniotic fluid volume (AFV). Fifty-eight and five fetuses did and did not show oligohydramnios, respectively, after being exposed to ARBs. Of the 58 fetuses that presented with oligohydramnios, 57 were exposed to ARBs at gestational week (GW)⩾20, and 19 exhibited resolution of oligohydramnios 1-6 weeks after cessation of ARBs. The 24 mothers without oligohydramnios at delivery ceased taking ARBs earlier (GW of 26.8±5.1 vs. 31.8±4.0, respectively, P=0.000) and had longer duration of gestation after cessation of ARBs (8.4±5.2 vs. 0.7±2.3 weeks, respectively, P=0.000). The mothers without oligohydramnios also had better outcomes in terms of favorable infant outcomes (63% (15/24) vs. 15% (6/39), respectively, P=0.000) and infant mortality rates (13% (3/24) vs. 56% (22/39), respectively, P=0.001) than the 39 with oligohydramnios. Thus, a favorable outcome may be feasible if the fetuses are not indicated for prompt delivery at presentation and exhibit normal AFV or resolution of oligohydramnios after cessation of ARBs. Although the prevalence rate of oligohydramnios was high in this study, it may have been due to publication bias. A prospective study suggested a lower prevalence rate than that reported in the present study.Hypertension Research advance online publication, 19 February 2015; doi:10.1038/hr.2015.12.
    Hypertension Research 02/2015; 38(5). DOI:10.1038/hr.2015.12 · 2.94 Impact Factor
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    ABSTRACT: Background There is conflicting information regarding the risk of gestational diabetes mellitus (GDM) in twin pregnancies. To determine whether the risk of GDM is higher in pregnant Japanese women with twin vs. singleton pregnancy.Methods The prevalence of GDM was studied in two different populations: 144589 women registered with the Japan Society of Obstetrics and Gynecology (JSOG cohort) over three years between 2007 and 2009 in which patient selection bias was unavoidable; and 430 Japanese women who gave birth at a single center over 5 years between 2008 and 2012 (Single-center cohort), consisting of 86 women with twins and 344 women with singletons matched for maternal age and pre-pregnancy body mass index. The GDM was diagnosed based on the previous criteria in the JSOG cohort. The GDM was screened in a stepwise method and diagnosed based on the new criteria in the Single-center cohort.ResultsIn the Single-center cohort, neither frequency of random glucose level ≥ 105 mg/dL in 1st trimester (9.0% [31/344] vs. 5.8% [5/86]), positive result (≥140 mg/dL) on 50 g glucose challenge test in 2nd trimester (26.5% [90/339] vs. 26.7% [23/86]), nor women diagnosed with GDM (8.4% [29/344] vs. 9.3% [8/86]) differed between the two groups. The prevalence of hyperglycemia was higher in singleton than twin pregnancies in the JSOG cohort (2.6% vs. 1.8%, P < 0.001).Conclusions The risk of GDM may be similar between Japanese women with singleton and twin pregnancies. Difference in the risk of hyperglycemia in the JSOG cohort may have been due to selection bias. This article is protected by copyright. All rights reserved.
    Diabetes/Metabolism Research and Reviews 02/2015; 31(2). DOI:10.1002/dmrr.2586 · 3.59 Impact Factor
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    ABSTRACT: Twin pregnancy is a risk factor of complications, such as pregnancy-induced hypertension, venous thromboembolism, and postpartum hemorrhage, the pathogenesis of which may involve aberrations of the coagulation-fibrinolysis system. Fibrinogen data for 129 and 1202 blood specimens from 84 and 902 women with twin and singleton pregnancies, respectively, at gestational week (GW)≥32 were analyzed retrospectively. None of the 986 women developed complications in which blood fibrinogen levels may be altered. Thirty-six and 288 women with twin and singleton pregnancies were examined longitudinally, respectively. The fibrinogen levels of 403±63 and 403±77mg/dL at GW 32 - 33 and 34 - 35, respectively, decreased significantly to 366±57mg/dL at GW 36-37 in women with twins, while corresponding levels (422±79, 420±65, and 415±64, respectively) and that at GW≥38 (408±60mg/dL) did not change significantly in women with singleton pregnancies. The fibrinogen levels determined within 3weeks before delivery were consistently and significantly lower in women with twin than singleton pregnancies. The fibrinogen levels were significantly inversely correlated with GW in women with twins (R=-0.36, P=0.002), but not in those with singleton pregnancies. The fibrinogen level of twin pregnancy decreases significantly and is significantly lower than that in singleton pregnancy in the last few weeks of pregnancy. Copyright © 2014. Published by Elsevier Ltd.
    Thrombosis Research 12/2014; 135(2). DOI:10.1016/j.thromres.2014.11.030 · 2.43 Impact Factor
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    ABSTRACT: Autophagy has not been studied extensively in the human placenta. This study was performed to determine whether autophagy is increased in the placentas of women with hypertensive disorders in pregnancy compared to normotensive pregnancies. LC3-II and p62 protein expression were examined by quantitative Western blotting analysis in 40 placentas from women not experiencing labor pains. The 40 placentas were from 13, 8, and 19 women with preeclampsia, gestational hypertension, and normal pregnancy, respectively. Hypertensive disorders in pregnancy included preeclampsia and gestational hypertension. LC3-II expression was significantly increased, while that of p62 was significantly reduced in 21 placentas of women with hypertensive disorders compared to those with normal blood pressure irrespective of the presence or absence of fetal growth restriction (FGR). LC3-II expression was also significantly increased in 13 placentas of women with preeclampsia irrespective of the presence or absence of FGR. The results of this study suggested that autophagy is active in the placenta of hypertensive disorders even in the absence of FGR. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Placenta 10/2014; 35(12). DOI:10.1016/j.placenta.2014.10.009 · 3.29 Impact Factor
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    ABSTRACT: The aim of this study was to provide better counsel to pregnant women with suspected placental mesenchymal dysplasia (PMD) regarding the risks of preterm birth and intrauterine fetal death. We reviewed the outcomes of 109 PMD pregnancies with gestational week (GW) ≥ 24 abstracted from 63 reports in the English-language published reports, including two cases that we encountered recently. The prospective risk of stillbirth at GW N was defined as the number of women with stillbirth at GW ≥ N divided by the number of women giving birth at GW ≥ N. A total of 32 (29.4%) women experienced stillbirth at a median GW of 31 (range, 24-38). Preterm birth (GW < 37) occurred in 52 (67.5%) of the 77 live-born infants. Only 25 (22.9%) women had full-term (GW ≥ 37) live-born infants. The prospective risks of stillbirth were 29.4% (32/109), 27.5% (25/91), 20.9% (14/67) and 13.0% (6/46) for women who reached GW 24(+0) , 28(+0) , 32(+0) and 36(+0) respectively. As women with PMD are at markedly elevated risk of intrauterine fetal death, early admission to the hospital and intensive monitoring of fetal status should be considered, although whether this policy improves outcome has not been validated. © 2015 Japan Society of Obstetrics and Gynecology.
    Placenta 10/2014; 35(10):A21-A22. DOI:10.1016/j.placenta.2014.08.081 · 3.29 Impact Factor
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    ABSTRACT: Keywords:prenatal diagnosis;chorionic villus sampling;amniocentesis;fetal trisomy;noninvasive prenatal genetic testing;prenatal screening test
    Ultrasound in Obstetrics and Gynecology 09/2014; DOI:10.1002/uog.14676 · 3.14 Impact Factor
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    ABSTRACT: The aim of this study was to determine whether antenatal decline in antithrombin (AT) activity occurs frequently and precedes the development of perinatal liver dysfunction in women with triplet pregnancies. A retrospective observational study was conducted on all women who gave birth to triplets at gestational week ≥22 at a single centre during a study period from January 2001 to March 2013. The following eight blood parameters were monitored weekly during the last 5 weeks of pregnancy and postpartum: AT activity, platelet count, fibrinogen, D-dimer, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), uric acid and creatinine. Pregnancy-induced AT deficiency (PIATD) and gestational thrombocytopenia were defined as antenatal AT activity <70% of normal level and antenatal platelet count <150 × 109/L, respectively. Liver dysfunction was defined as AST > 40 IU/L. LDH elevation was defined as LDH > 450 IU/L. Sixteen women were eligible for this study. All variables except LDH exhibited significant changes antenatally: AT activity, platelet count and fibrinogen decreased, while D-dimer, AST, urate and creatinine increased. LDH increased significantly postpartum. PIATD, gestational thrombocytopenia, perinatal liver dysfunction, and LDH elevation occurred in eight, seven, six, and eight women, respectively. Liver dysfunction was preceded by PIATD alone in three, by both PIATD and gestational thrombocytopenia in one and by gestational thrombocytopenia alone in none of the subjects. After delivery, laboratory abnormalities similar to HELLP syndrome were seen in three women exclusively in the presence of PIATD. Reduced AT activity was likely to precede perinatal liver dysfunction in women with triplets.
    Journal of Obstetrics and Gynaecology Research 08/2014; 40(12). DOI:10.1111/jog.12470 · 0.93 Impact Factor
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    ABSTRACT: To determine whether macrosomic infants with a birthweight of 4.0 kg or more have increased risk of cerebral palsy associated with neonatal encephalopathy (Enc-CP).
    Journal of Obstetrics and Gynaecology Research 06/2014; 40(6):1611-7. DOI:10.1111/jog.12367 · 0.93 Impact Factor
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    ABSTRACT: Background It is unclear whether antenatal fibrinogen concentrations are associated with postpartum haemorrhage. Methods This retrospective study included 871 women with a singleton pregnancy but no known risk factors for postpartum haemorrhage, in whom fibrinogen concentration was measured within the 21 days before delivery. Correlation between antenatal fibrinogen concentrations and estimated blood loss was analysed. We tested the hypothesis that the risk of postpartum haemorrhage was higher in women with antenatal fibrinogen concentration of <3.3 g/L. Postpartum haemorrhage was defined as an estimated blood loss ⩾700 mL following vaginal delivery and ⩾1000 mL following caesarean delivery. Results In women delivering vaginally (n=337), estimated blood loss tended to increase with decreasing antenatal fibrinogen concentration (R= -0.107, P=0.05), median fibrinogen concentration was significantly lower in 69 women with postpartum haemorrhage than in 268 women without postpartum haemorrhage (3.93 vs. 4.18 g/L, P=0.025), and postpartum haemorrhage occurred significantly more often in women with fibrinogen concentrations <3.3 g/L than in those with concentrations ⩾3.3 g/L (38% [11/29] vs. 19% [58/308], P=0.018). In women undergoing caesarean delivery (n=534), median fibrinogen concentration did not differ between those who experienced postpartum haemorrhage (n=128) and those who did not (n=406) (4.18 g/L vs. 4.07 g/L, P=0.43). Antenatal fibrinogen concentrations of <3.3 g/L were not associated with higher rates of postpartum haemorrhage (26% [11/43] vs. 24% [117/491], P=0.80). Conclusions Antenatal fibrinogen concentration <3.3 g/L may be a risk factor for postpartum haemorrhage among women following vaginal delivery.
    International Journal of Obstetric Anesthesia 06/2014; 23(4). DOI:10.1016/j.ijoa.2014.06.004 · 1.83 Impact Factor
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    ABSTRACT: There has been only one case to date of pregnancy outcome after fundal transverse cesarean section (FTC). We report a pregnancy established after FTC. The FTC was performed at gestational week (GW) 24 in this patient's first pregnancy, but the uterus was preserved. Magnetic resonance imaging studies performed four times in her second pregnancy consistently showed part of the uterine fundus in which the muscle layer was interrupted. Concern regarding spontaneous uterine rupture in the absence of labor pains prompted us to interrupt her pregnancy at GW 31+5, delivering a premature, but otherwise healthy female infant, weighing 1832 g. The infant required transient intratracheal intubation for respiratory distress syndrome (for less than 1 h), but had an otherwise uneventful clinical course. Two cases, including ours, suggest that successful pregnancy outcome is feasible at least in some women with uterine scarring due to FTC.
    Journal of Obstetrics and Gynaecology Research 05/2014; 40(5). DOI:10.1111/jog.12361 · 0.93 Impact Factor
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    ABSTRACT: Some women with isolated gestational proteinuria (IGP) later develop hypertension and are diagnosed with pre-eclampsia (PE). This study was performed to determine whether clinical features of such proteinuria preceding PE (P-PE) differ from those of other PE (O-PE). Retrospective observational study after approval of the institutional review board of ethics. A single university hospital. Proteinuria was defined as a protein-to-creatinine ratio (mg/mg; P/Cr) of ≥0.27 in the spot urine specimen. IGP was defined as proteinuria in the absence of hypertension. P-PE was defined as PE in which proteinuria preceded hypertension by more than 2 days. All of 10 and 18 consecutive women with P-PE and O-PE, respectively, who gave birth between January 2008 and August 2013. Proteinuria appeared earlier (at 30.2±3.0 vs 35.3±4.3 weeks, p=0.001), the P/Cr level was greater at birth (7.28±2.14 vs 3.19±2.49, p<0.001), net maternal weight gain during the last antenatal 1 week was greater (3.1±1.8 vs 1.3±1.7 kg, p=0.023) and length of pregnancy was shorter (32.5±1.9 vs 36.1±3.6 weeks, p=0.001) in women with P-PE than in O-PE. The duration of IGP was 10.0±5.9 days (range 3-20), and the time interval until delivery after diagnosis of PE was 6.1±8.2 days (range 0-23) in 10 women with P-PE. The P/Cr levels at birth were significantly inversely correlated with the antenatal lowest antithrombin activity and fibrinogen levels among the 28 women with PE. Women with P-PE were likely to exhibit greater proteinuria in the urine, greater water retention in the interstitial space and more enhanced coagulation-fibrinolysis, thus suggesting that they may constitute a more severe form of PE than women with O-PE do.
    BMJ Open 04/2014; 4(4):e004870. DOI:10.1136/bmjopen-2014-004870 · 2.06 Impact Factor
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    ABSTRACT: As proposed criteria (Swansea criteria) for the diagnosis of acute fatty liver of pregnancy (AFLP) do not include antithrombin (AT) activity, diagnosis of AFLP may be delayed. The aim of this review is to underscore problems in the differential diagnosis of AFLP and the syndrome of hemolysis, elevated liver enzymes and low platelet counts (HELLP syndrome) and to facilitate prompt diagnosis of AFLP. Published works dealing with liver dysfunction in pregnancy, HELLP syndrome and AFLP were reviewed. AFLP and HELLP syndrome shared common clinical, laboratory, histological and genetic features, and differential diagnosis between them was often difficult. However, HELLP syndrome was likely to occur in patients with hypertension, but AFLP occurred often in the absence of hypertension. In addition, AFLP was exclusively associated with pregnancy-induced antithrombin deficiency (PIATD). Approximately 50% of patients with AFLP did not have thrombocytopenia at presentation. As the Swansea criteria for AFLP did not include PIATD, diagnosis of AFLP was delayed until manifestation of life-threatening complications; 60% of women were admitted to intensive care and 15% to a specialist liver unit. In conclusion, incorporation of AT activity of less than 65% into the diagnostic criteria for AFLP may facilitate suspicion and prompt diagnosis of AFLP, decrease uncertainty regarding the diagnosis of AFLP, and contribute to better investigation and understanding of the process leading to the development of liver dysfunction.
    Journal of Obstetrics and Gynaecology Research 01/2014; 40(3). DOI:10.1111/jog.12282 · 0.93 Impact Factor
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    ABSTRACT: Abstract Aim: It is unknown whether weekly maternal weight gain differs between Japanese women with singleton, twin, and triplet pregnancies. Methods: Gestational weight gain defined as net weight gain during pregnancy was analyzed in 135,036 pregnant Japanese women, including 128,838 with singletons, 5573 with twins, and 132 with triplets, who gave birth at ≥22 weeks of gestation between 2007 and 2009. Weekly weight gain was defined as follows: gestational weight gain÷[gestational week (GW) at Delivery-2]. Results: Length of gestation (weeks, mean±SD) decreased significantly (38.2±2.6, 35.3±3.0, and 32.7±2.8) with increasing number of fetuses, while overall gestational weight gain (kg) was significantly smaller in women with singletons than in those with either twins or triplets (9.6±4.4 vs. 10.9±4.8 or 10.9±5.2, respectively). Thus, weekly maternal weight gain (kg/week) increased significantly with increasing number of fetuses (0.26±0.12, 0.33±0.13, and 0.35±0.16). Among women with delivery at or after GW 34, difference in gestational weight gain (kg) was prominent between the three groups (9.8±4.4, 11.4±4.7, and 13.0±5.1 for singleton, twin, and triplet pregnancies, respectively, P<0.001 between any two groups). Conclusions: Weekly maternal weight gain increases with increasing number of fetuses. Our figures may be useful for advising Japanese women with multifetal pregnancies regarding gestational weight gain.
    Journal of Perinatal Medicine 12/2013; 42(4):1-6. DOI:10.1515/jpm-2013-0211 · 1.43 Impact Factor
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    ABSTRACT: The risk of abortion is known to be high in women with essential thrombocythemia (ET). However, a few studies have focused on the risk of stillbirth among fetuses reaching gestational age compatible with life. Review of medical charts of pregnant women with ET who received cares at a single center between January 2003 and June 2013 and the English literature in which more than 20 pregnancies with ET were dealt with regarding outcomes. Outcomes were classified into three categories: spontaneous abortion or preterm delivery before GW 24, stillbirth at and after GW 24, and live birth (LB). Japan national statistics was used to estimate the risk of stillbirth among women with GW 22 or more. In all nine pregnancies in four women with ET at our hospital, two miscarriages, one stillbirth (intrauterine death at GW 35), and six LBs occurred. There were six reports in the English literature in which a total of 374 pregnancy outcomes were described: 110 miscarriages (29%), 14 stillbirths (3.7% of all 374 pregnancies and 5.3% of 264 pregnancies with GW≥24), and 250 LBs (67%) occurred. Japan national statistics between 1995 and 2011 indicated that the risk of stillbirth was less than 0.50% among women with GW≥22. The risk of stillbirth was extremely high among women with ET. More intensified monitoring of fetal wellbeing may be required to improve outcome of pregnancy complicated with ET.
    Thrombosis Research 11/2013; 133(2). DOI:10.1016/j.thromres.2013.11.004 · 2.43 Impact Factor
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    ABSTRACT: The aim of this study was to underscore problems associated with the dipstick test and determination of protein concentration alone in spot-urine (P-test) compared with spot-urine protein-to-creatinine ratio (P/Cr test) and to determine whether urine collection for 24-h test was complete. Dipstick and P/Cr tests were performed simultaneously in 357 random spot-urine specimens from 145 pregnant women, including 35 with pre-eclampsia. Positive results were defined as ≥1+ on dipstick test, protein concentration ≥30 mg/dL on P-test, and P/Cr ratio ≥ 0.27 (mg/mg) on P/Cr test. Sixty-four 24-h urine tests (quantification of protein in urine collected during 24 h) were performed in 27 of the 145 women. We assumed that P/Cr ratio ≥ 0.27 predicted significant proteinuria (urinary protein ≥ 0.3 g/day). The 24-h urine collection was considered incomplete when urinary creatinine excretion was <11.0 mg/kg/day or >25.0 mg/kg/day. Forty-four percent (69/156) of specimens with a positive test result on dipstick test contained protein < 30 mg/dL. Dipstick test was positive for 25.7% (69/269) of specimens with protein < 30 mg/dL and for 28.8% (79/274) of specimens with P/Cr ratio < 0.27. P-test results were positive for 7.3% (20/274) and negative for 18.1% (15/83) of specimens with P/Cr ratio < 0.27 and ≥0.27, respectively. Incomplete 24-h urine collection occurred in 15.6% (10/64) of 24-h urine tests. Daily urinary creatinine excretion was 702-1397 mg, while creatinine concentration varied from 16 mg/dL to 475 mg/dL in spot-urine specimens. Dipstick test and P-test were likely to over- and underestimate risks of significant proteinuria, respectively. The 24-h urine collection was often incomplete.
    Journal of Obstetrics and Gynaecology Research 09/2013; 40(1). DOI:10.1111/jog.12148 · 0.93 Impact Factor
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    ABSTRACT: Women with imminent premature labor (IPL) are transported to a tertiary hospital equipped with neonatal intensive care unit (NICU) even during the night. However, there have been no extensive studies of the occurrence rate of night IPL. The aim of this study was to determine the occurrence rate of night IPL in an area with a population of 2 million. A retrospective analysis was conducted using data collected by the Sapporo Obstetric System for Emergency Patients launched in October 2008, in which women, physicians, and ambulance staff who sought appropriate obstetric/gynecological facilities available in the night (19.00-06.00 hours) were informed of candidate hospitals by coordinators through telephone consultation. This system covered the Sapporo area, which has a population of 2 000 000 and 17 000 births annually. Approximately 14% and 86% of women received antenatal care at six and 35 obstetric facilities with and without NICU, respectively, in this area. Night IPL was defined as a threatened premature labor and transport to one of six tertiary hospitals with NICU between 19.00 and 06.00 hours the next morning. During a 4-year period from 1 October 2008 to 30 September 2012, the Sapporo Obstetric System for Emergency Patients received 158 ± 23 (mean ± standard deviation) monthly telephone consultations (range 114-218 per month). The monthly number of patients with night IPL was 3.0 ± 2.2 (range 0-9 per month). The monthly number of cases of night IPL was around three among women who received antenatal care at obstetrics facilities without NICU in an area with a population of 2 000 000.
    Journal of Obstetrics and Gynaecology Research 07/2013; 39(12). DOI:10.1111/jog.12113 · 0.93 Impact Factor
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    Open Journal of Obstetrics and Gynecology 01/2013; 03(09):680-682. DOI:10.4236/ojog.2013.39124
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    ABSTRACT: Introduction The risk of abortion is known to be high in women with essential thrombocythemia (ET). However, a few studies have focused on the risk of stillbirth among fetuses reaching gestational age compatible with life. Methods Review of medical charts of pregnant women with ET who received cares at a single center between January 2003 and June 2013 and the English literature in which more than 20 pregnancies with ET were dealt with regarding outcomes. Outcomes were classified into three categories: spontaneous abortion or preterm delivery before GW 24, stillbirth at and after GW 24, and live birth (LB). Japan national statistics was used to estimate the risk of stillbirth among women with GW 22 or more. Results In all nine pregnancies in four women with ET at our hospital, two miscarriages, one stillbirth (intrauterine death at GW 35), and six LBs occurred. There were six reports in the English literature in which a total of 374 pregnancy outcomes were described: 110 miscarriages (29%), 14 stillbirths (3.7% of all 374 pregnancies and 5.3% of 264 pregnancies with GW ≥ 24), and 250 LBs (67%) occurred. Japan national statistics between 1995 and 2011 indicated that the risk of stillbirth was less than 0.50% among women with GW ≥ 22. Conclusions The risk of stillbirth was extremely high among women with ET. More intensified monitoring of fetal wellbeing may be required to improve outcome of pregnancy complicated with ET.
    Thrombosis Research 01/2013; · 2.43 Impact Factor