Nobuhiro Hidaka

Fukuoka City Hospital Organization · Fukuoka Children's Hospital Department of Obstetrics

Purpose: A safety trial for early fetal treatment before 26 gestational weeks to improve the neurological prognosis of fetuses with myelomeningocele (MMC) was conducted in Japan. The aim of the study was to examine the prenatal diagnostic background and postnatal outcomes of fetuses with MMC at our institution and identify future challenges for fet...

We report an extremely challenging case of fetal goitrous hypothyroidism involving all three fetuses of a triplet pregnancy in which successful fetal treatment led to a favorable pregnancy outcome. The patient had a trichorionic, triamniotic triplet pregnancy and was referred to us at 24 weeks gestation after goiters affecting all three fetuses and...

Fetal cardiac hypertrophy (CH) in pregnant women with diabetes is believed to be a benign condition. We encountered a rare case of fetal CH in a pregnant woman with type 1 diabetes, which developed into severe fetal circulatory insufficiency and acidemia. Fetal echocardiography at 37-week gestation showed cardiomegaly with a ventricular hypertrophy...

Objective To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer Design Prospective cohort study with a historical cohort Setting University hospital Population Twelve pregnancies in ten women were included in the VP group between October...

Objective To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer Study Design This is an interventional study with a historical cohort. For the interventional study participants who had singleton pregnancies after AT between October 2016...

A 35-year-old primigravid woman with chronic idiopathic intestinal pseudo-obstruction presented to our institution. Except for an enlarged fetal bladder, her pregnancy was almost uneventful until she developed pre-eclampsia requiring emergent cesarean section at 34 weeks gestation. After delivery, intractable uterine atony developed with blood loss...

Objective To investigate the outcome of pregnancies with small baby, including both small for gestational age (SGA) and late fetal growth restriction (FGR) fetuses, undergoing induction of labor (IOL) with Dinoprostone, Misoprostol or mechanical methods. Study design Medline, Embase and Cochrane databases were searched. Inclusion criteria were non...

We successfully performed shunting for a fetus with a multilocular macrocystic lung mass with hydrops at 22 weeks' gestation. Complete resolution of hydrops was achieved; however, at 35 weeks' gestation, the fetus developed acute massive pleural effusion. Fetal ultrasound examination revealed that one end of the shunting tube had migrated downward...

Background Mother-infant bonding is an emerging perinatal issue. While emergency cesarean deliveries are associated with a risk of bonding disorders, the mode of anesthesia used for emergency cesarean deliveries has never been studied in this context. We aimed to investigate the impact of administering general anesthesia and neuraxial anesthesia to...

Gastric cancer involving the placenta during pregnancy is rare; however, we present 1 such case in this report. A 31-year-old Japanese woman was referred at 26 weeks of gestation for the evaluation of a swollen left supraclavicular lymph node. Biopsy revealed poorly differentiated adenocarcinoma, and esophagogastroduodenoscopy with biopsy of the st...

Hydrops fetalis in association with meconium peritonitis is a rare condition, and the mechanism underlying hydropic changes has not been fully recognized. We present a case of fetal meconium peritonitis with hydrops and coagulopathy. Clinically, the cause of fetal disseminated intravascular coagulation is considered to be a consequence of a systema...

Although some cases describing delayed birth of the second twin have been published recently, delay of delivery beyond 36 weeks seems scarce. We report a case of delayed-interval delivery wherein prolongation of the second twin's delivery until term with a subsequent favorable infantile outcome. In this case, the stillbirth of the first twin occurr...

Although an ectopic intrathoracic kidney can be complicated by congenital diaphragmatic hernia (CDH), prenatal diagnosis of this condition is rare. We report a rare case of prenatally diagnosed ectopic intrathoracic kidney with CDH presenting as fetal mesocardia. A 32-year-old gravida 1, para 0 showed fetal mesocardia on ultrasonographic screening...

A 39-year-old mother was referred to us at 20 gestational weeks owing to a large fetal left lung multilocular mass (macrocystic CPAM) and minimal ascites. The overall size of the mass lesion corresponded to a CPAM volume ratio (CVR) of 1.61. Placentomegaly was also noted. On admission at 22 weeks’ gestation, the fetus exhibited skin edema, and hydr...

Introduction Although nonabsorbable woven tape has been widely used for cervical cerclage, technical difficulties that can occur with an effaced cervix because of the thickness of the tape, and the risks of local infection are two major concerns. This study investigated perinatal outcomes of pregnancies involving an emergency cervical cerclage usin...

We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 w...

Pregnancy after mechanical valve replacement involves high risk. Maternal valve thrombosis and hemorrhagic complications are associated with lethal outcomes; therefore, strict anticoagulant therapy is needed. Our patient was 26-year-old primiparous woman. She had undergone aortic valve replacement with a mechanical valve at 4 years of age and had u...

BACKGROUND: Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. Early termination is commonly performed for fear of massive bleeding and uterine rupture. Only a few cases of CSP continuation resulting in viable delivery have been reported, and almost all of these were singleton pregnancies. CASE: We present a rare case of CSP and suc...

Objectives: Although the efficacy of thoracoamniotic shunting (TAS) for fetal hydrothorax is well-recognized, the coexistence of hydrops fetalis is still a clinical challenge. The preoperative determinants of shunting efficacy are not fully understood. In this study, we aimed to investigate the perinatal and postnatal outcomes of hydrops fetalis w...

Although fibrosis is one of the most prominent pathological features of preeclamptic (PE) placentas, its mechanism remains largely unknown. Consistent with previous reports, we observed overexpression of collagen; actin, alpha 2, smooth muscle, aorta; connective tissue growth factor; and fibronectin in PE placentas compared with control ones. To in...

Objective: We aimed to evaluate the outcomes of growth-restricted fetuses with absent end-diastolic velocity in the umbilical arteries (UA-AEDV), and investigate the relationship between Doppler flow velocity waveforms in the ductus venosus (DV) and the clinical features. Materials and methods: This was a retrospective study of growth-restricted...

Aim: To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. Methods: We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries an...

We aimed to investigate whether the lung-to-thorax transverse area ratio (LTR) immediately before birth is of diagnostic value for the prediction of postnatal short-term outcomes in cases of isolated left-sided congenital diaphragmatic hernia (CDH). We retrospectively reviewed the cases of fetal isolated left-sided CDH managed at our institution be...

Twin anemia-polycythemia sequence (TAPS) is characterized by the presence of a small number of minuscule arterio-venous (AV) anastomoses on the placental surface, and arterio-arterial (AA) anastomoses are hardly observed. We encountered a case of TAPS with not only two AV anastomoses but also a single AA anastomosis on the placenta. In this case, t...

Background: Trachelectomy was developed as a fertility-sparing surgery for early-stage cervical cancer in patients of childbearing age. The purpose of this study is to evaluate oncologic and obstetric outcomes and complications after abdominal trachelectomy. Methods: We began to perform abdominal trachelectomy in 2005. Our institutional review b...

Cytomegalovirus (CMV) infection is the most common intrauterine infection worldwide, and the clinical manifestations are potentially severe. Typically, the diagnosis of acute CMV infection in pregnancy is based on positive results for maternal IgM. Herein, we present a case of a fetal CMV infection in which maternal CMV-specific IgM antibodies were...

Although the role of interventional radiology in the field of obstetrical hemorrhage has been widely reported upon recently, the rate of procedure-related complications has not been fully determined. We present the case of a patient who developed an external iliac artery thrombosis, a rarely reported complication associated with prophylactic common...

We present a patient with prenatally diagnosed congenital left diaphragmatic hernia, in whom complete agenesis of the left lung was found postnatally. The fetal sonographic examination was not suggestive of a poor prognosis (lung to thorax transverse area ratio, 0.17; observed/expected lung area to head circumference ratio, 51%). The stomach was in...

In this report, we present a case of twin-twin transfusion syndrome in the presence of the thick dividing wall of each sac in dichorionic twins. The dichorionic diagnosis was based on the presence of the lambda sign at the first-trimester ultrasound evaluation. In addition to fetoscopic and pathological investigation, DNA typing confirmed that the...

We encountered a patient with a fetal cytomegalovirus infection manifesting as pancytopenia and thoracic hypoplasia. The fetal anemia was treated by transfusion via the umbilical cord, and did not progress after 22 weeks’ gestation. The neutropenia resolved spontaneously, and only thrombocytopenia was persistent at birth. The severe thoracic hypopl...

Cervico-isthmic pregnancies (CIP) are often complicated by massive hemorrhage due to placenta previa and adhesion. Herein, we present a case of CIP without placenta previa, complicated by cervical incompetency. A 39-year-old multiparous woman was diagnosed with CIP at 8 weeks. The placenta was located on the normal site, and no significant ultrason...

It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63 mm × 50 mm × 74 mm, was observed below the right lobe of the liver, and the presumptive antena...

We aimed to investigate which factors in the clinical profile of mothers with idiopathic thrombocytopenic purpura (ITP) can predict neonatal risk of thrombocytopenia. Data was retrospectively collected from all pregnant women with ITP who presented to our institution between 2001 and 2013. Neonatal offspring of these women were classified into 2 gr...

It is rare for an ovarian artery aneurysm to rupture during the peripartum period, but the outcome can be catastrophic. Between 1980 and 2013, only nine cases have been reported in the English-language medical published work. We describe a patient with a left ovarian artery aneurysm that ruptured 4 days after an uneventful vaginal delivery. The rup...

Objective Observed/expected lung area to head circumference ratio (o/e LHR) and lung to thorax transverse area ratio (LTR) are the sonographic indicators of postnatal outcome in fetuses with congenital diaphragmatic hernia (CDH), and they are not influenced by gestational age. We aimed to evaluate the relationship between these 2 parameters in the...

We present a case of fetal severe micrognathia in which successful airway stabilization was achieved by an ex utero intrapartum treatment procedure. In this case, it was anticipated that the infant would have a vulnerable airway at birth based on in utero sonographic findings, including an extremely hypoplastic jaw, worsening polyhydramnios and abs...

We aimed to investigate the clinical characteristics and postnatal outcomes of fetuses with congenital diaphragmatic hernia (CDH) and additional anomalies. We reviewed the charts of fetuses with CDH managed between 2005 and 2013. Patients were divided into complex and isolated groups based on the presence of additional anomalies. We analyzed the re...

Fetal congenital cystic adenomatoid malformation (CCAM) can progress to nonimmune hydrops, and the mortality rate of CCAM with hydrops is reported to be nearly 100%. We describe three microcystic CCAM cases in which the fetal condition improved after maternal betamethasone therapy. The median gestational age at steroid administration was 23 5/7 wee...

A co-existing right congenital diaphragmatic hernia and omphalocele is rare. We present images of a fetus diagnosed with this rare combination of anomalies. Early neonatal death occurred immediately after the full-term birth due to severe respiratory insufficiency. In this case, disturbance of chest wall development due to the omphalocele rather th...

Fetal borderline ventriculomegaly represents a frequent dilemma in perinatal management. The present study aimed to evaluate the clinical significance of fetal borderline ventriculomegaly in a low-risk Japanese population and to identify the risk factors for associated anomalies. Data of cases of fetal borderline ventriculomegaly detected at 26-28...

The combination of congenital cystic adenomatoid malformation of the lung (CCAM) and hydrops fetalis entails compromised birth outcomes, and fetuses with a CCAM volume ratio (CVR)>1.6 are considered at high risk for the development of hydrops. A 33-year-old gravida 3, para 1, mother was admitted at 20+6 weeks of gestation owing to a large fetal lun...

We aimed to investigate whether the ratio of magnetic resonance imaging (MRI)-measured right lung volume (RLV) to ultrasonography-estimated bodyweight (RLV/BW) and observed-to-expected (o/e) RLV are of diagnostic value in predicting postnatal outcomes of left congenital diaphragmatic hernia (CDH). We included 32 CDH patients and 34 control subjects...

Congenital megalourethra is a rare urogenital malformation that is usually associated with lower urinary tract obstruction. In association with hypoplasia or deficiency of the corpus spongiosa and/or corpus cavernosum, a cystic dilatation of penile urethra is generally observed. We present a case of congenital megalourethra diagnosed by fetoscopy a...

We report a case of severe congenital diaphragmatic hernia accompanied by hydrops fetalis in a fetus conceived by a 33-year-old woman. Fetal magnetic resonance imaging performed at 27 weeks of gestation revealed herniation of the stomach, bowel, and left liver into the thoracic cavity, confirming severe left-sided CDH. Presence of hydrops fetalis a...

Although prenatal diagnosis of congenital diaphragmatic hernia is not a rare event, detection of intrathoracic kidney in association is extremely rare. We present the sonographic findings in such a case. The postnatal outcome after successful respiratory management and surgical repair was good. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound, 2011...

Aim: The objective of this study was to evaluate the significance of maternal toxoplasmosis, rubella, cytomegalovirus (CMV) and herpes simplex virus (TORCH) screening in cases of fetal growth restriction (FGR). Material and methods: The medical records of women carrying fetuses with FGR who underwent TORCH screening over a 10-year period were re...

The aim of this study was to evaluate the perinatal outcome of monochorionic diamniotic (MD) twin gestations managed from early gestation onward at a single center. This was a retrospective single-cohort study, spanning 6 years, of 219 MD twin pregnancies who received prenatal care before 14 weeks of gestation and delivered at our center. The subje...

We present a case of an antenatally diagnosed congenital aneurysm of the left ventricle in which fetal cardiac contractility was evaluated by measuring the fetal isovolumetric contraction time (ICT). The workup of the fetus at 26 weeks' gestation led to the identification of a left ventricle aneurysm. Initially, the value of ICT of the left ventric...

Incarceration of the gravid uterus is a rare but serious complication of pregnancy. The often required cesarean section is technically complicated, and preoperative planning is critical. An important initial surgical step is to lift the fundus out of the pelvis prior to creating the hysterotomy in order to facilitate adequate visualization of the p...

Pulmonary sequestration is defined as nonfunctional lung tissue that lacks communication with the bronchial tree and that is supplied by an anomalous systemic vessel. In comparatively rare cases, pulmonary sequestration may lead to hydrothorax or hydrops fetalis, which is nearly universally fatal. In this report, we describe a case of pulmonary seq...

Results: We demonstrated a correlation between PSV of renal artery, PI and vmax of renal vein and gestational age (GA). In addition our results showed that there were no correlation between gestational age and 3-D power Doppler vascular parameters (VI, FI, VFI). Conclusions: Our study indicates that fetal renal blood flow increase with the advancem...

We have summarized the care management of pregnant women with complete atrioventricular block (CAVB) by reviewing data from the published literature as well as our own experience in 32 pregnancies. Obstetrical management of women with a permanent pacemaker implanted prior to conception has been sufficiently reported thus far, and the management of...

Takayasu arteritis predominantly affects young women of reproductive age; therefore, the management of pregnancies with this disease is of great importance in clinical obstetrics. However, only a limited number of such cases have been reported in the English literature. Our aim in this study was to investigate the clinical features of pregnant wome...

An abdominal aortic aneurysm is a rare disease in the paediatric population and is mainly caused by intrauterine infection, connective tissue diseases, such as Ehlers-Danlos syndrome and Marfan's syndrome, and iatrogenic trauma due to umbilical artery catheterization. Although several cases have been reported in the English literature, they were ra...

Klippel-Trenaunay syndrome (KTS) is a rare congenital disease, and extensive cutaneous hemangiomas and abnormal venous vessels are characteristic. In our case, to manage her pregnancy with KTS, whole-body MRA was performed before delivery. A 29-year-old woman was referred at 28 weeks because of prominent vulvovaginal varicosities due to KTS. At 35...

Cardiac hypertrophy in the recipient fetus of twin-twin transfusion syndrome (TTTS) has been reported previously. We encountered an unusual set of monochorionic twins in which one twin had cardiac hypertrophy without TTTS while the other fetus had selective growth restriction. In this case, the diagnosis of selective growth restriction was made at...

Absence of the ductus venosus (ADV) is a rare vascular anomaly; however, the advent of color Doppler sonography has facilitated detailed analysis of the fetal venous system, and prenatal diagnosis has been described in the recent literature.1-16 The ductus venosus is a short vascular channel with a maximum diameter of 2 mm, which connects the intra...

We have summarized the care management of pregnant women with complete atrioventricular block (CAVB) by reviewing the data from previous literature and our experience including 29 births. The management of patients already implanted with a permanent pacemaker does not involve any risks. Some of the patients without permanent pacemaker may develop s...

We have summarized the care management of pregnant women with complete atrioventricular block (CAVB) by reviewing the data from previous literature and our experience including 29 births. The management of patients already implanted with a permanent pacemaker does not involve any risks. Some of the patients without permanent pacemaker may develop s...

We aimed to investigate whether the preload index of the inferior vena cava (PLI-IVC) is of diagnostic value in predicting hydropic changes in fetuses with Ebstein anomaly. Five cases of prenatally diagnosed Ebstein anomaly, which were managed at our institution between 1999 and 2008, were retrospectively reviewed. The PLI-IVC was calculated as the...

Sacrococcygeal teratomas have been diagnosed prenatally on sonograms as masses of cystic, solid, or mixed echogenicity from the sacral area and protruding through the perineum or buttocks. However, a cystic sacrococcygeal teratoma may be misdiagnosed as an anterior sacral meningomyelocele, especially when presenting as a posterior cystic mass. We r...

Persistent truncus arteriosus is an uncommon congenital cardiac anomaly. In most patients, this condition is not diagnosed prior to birth. We report a case in which this uncommon cardiac anomaly was diagnosed prenatally using wide-band Doppler imaging. When diagnosing fetal truncus arteriosus, sonologists should carefully search for the origin of t...

Fetal urinary ascites is a condition that is rarely encountered. A review of previous reports suggests that the clinical course of the affected fetuses is highly variable. In this report, we describe a case in which urinary ascites was observed after vesicocentesis in a fetus with megacystis caused by posterior urethral valve. The urinary ascites w...

To identify the clinical characteristics of fetal abdominal wall defects managed at a single institution and to provide information regarding the most likely clinical course of the affected fetuses. A retrospective review was conducted of 44 fetuses prenatally diagnosed with abdominal wall defects at Kyushu University Hospital between 1990 and 2006...

Trisomy 16 mosaicism detected at midtrimester amniocentesis is rare and indicative of true fetal mosaicism. We report a case of mosaic trisomy 16 diagnosed by amniocentesis in which the sonographic findings included fetal pulmonary artery stenosis, a single umbilical artery, and early onset fetal growth restriction. The pregnancy was legally termin...

Background: The objectives in this report are to present data on echocardiographic imaging of fetuses with congenital structural heart diseases using wide-band Doppler and to discuss the practical application of this unique display modality in the field of fetal echocardiography. Methods: We performed fetal echocardiography using wide-band Doppler...

To investigate the association between the presence of liver herniation and perinatal course and outcome of fetal omphalocele. Cases of fetal omphalocele managed at our hospital between 1990 and 2006 were retrospectively reviewed and grouped according to the location of the liver. Thirty-three fetal omphalocele cases were diagnosed. The chromosomal...

Prenatal sonographic findings of lymphangiomas characteristically appear as thin-walled, multiseptate hypoechogenic masses. In our case, a retroperitoneal hypoechogenic mass was detected at 26 weeks of gestation by sonography. Serial sonographic examinations demonstrated multiple septations at 29 weeks of gestation, which in retrospect was a classi...

We present a case of a pregnant woman with hereditary antithrombin III deficiency and deep vein thrombosis of the left lower extremity managed by perinatal unfractionated heparin injection with antithrombin III replacement as well as by intrapartum placement of a temporary inferior vena cava filter. A massive thrombus of the right common iliac vein...

Although fetal hydrothorax is uncommon, perinatal mortality from it is high. The clinical course of fetal hydrothorax is highly variable. Despite some cases of spontaneous resolution, fetal hydrothorax progresses to nonimmune hydrops because of impaired venous return and congestive cardiac failure due to compression in many cases. Although the effe...

It is well documented that asplenia syndrome is frequently associated with complex congenital heart diseases.(1-3) In addition, infants with asplenia syndrome are also likely to have a variety of gastrointestinal abnormalities,(1,2,4-6) and treatment to prevent or minimize gastrointestinal complications is currently emphasized. Some previous report...