研究者データベース

馬詰 武(ウマヅメ タケシ)
北海道大学病院 小児・周産・女性科
講師

基本情報

所属

  • 北海道大学病院 小児・周産・女性科

職名

  • 講師

学位

  • PhD(北海道大学)

科研費研究者番号

  • 00807935

J-Global ID

研究キーワード

  • 循環動態   産科   

研究分野

  • ライフサイエンス / 胎児医学、小児成育学 / 母体の循環・代謝

職歴

  • 2021年05月 - 現在 北海道大学病院 産科 講師
  • 2021年04月 - 現在 北海道大学病院 周産母子センター 副部長
  • 2017年04月 - 2022年04月 北海道大学病院 産科 助教・病棟医長
  • 2007年04月 - 2008年03月 北海道大学病院 卒後臨床研修センター 初期研修医

学歴

  • 2013年04月 - 2017年03月   北海道大学大学院医学研究科   生殖発達医学講座 産科・生殖医学分野
  •         - 2007年03月   北海道大学   医学部   医学科

所属学協会

  • 日本周産期・新生児医学会   日本産科婦人科学会   

研究活動情報

論文

  • Yasuo Haruyama, Etsuko Miyagi, Gen Kobashi, Soichiro Obata, Takeshi Umazume, Asuka Yoshimi, Akitoyo Hishimoto, Kentaro Kurasawa, Yukio Suzuki, Tomoaki Ikeda, Tadashi Kimura, Hideto Yamada
    Scientific reports 12 1 14042 - 14042 2022年08月18日 
    To investigate the relationships between communicative and critical health literacy (CCHL) and anxiety and depressive symptoms (ADs) in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was conducted and 5466 pregnant women responded in Japan in September 2020. A Kessler 6 scale (K6) score ≥ 10, an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13, and four CCHL groups were analyzed using a logistic regression model and trend test. The proportions of pregnant women with a K6 score ≥ 10 and EPDS score ≥ 13 were 13.5 and 15.4%, respectively. In comparisons with the low CCHL group, the adjusted odds ratio (95% CI) for anxiety symptoms was 0.770 (0.604-0.982) in the high CCHL group, while those for depressive symptoms were 0.777 (0.639-0.946), 0.665 (0.537-0.824), and 0.666 (0.529-0.838) in the lower, higher, and high CCHL groups (all p < 0.05), respectively, after adjustments for potential confounding factors, such as age, weeks of gestation, complications, history, number of children, marital status, education, employment, and income. Higher CCHL was associated with significantly lower adjusted odds ratios for anxiety (p for trend = 0.019) and depressive symptoms (p for trend < 0.001). These results suggest a relationship between CCHL and ADs in pregnant women during the COVID-19 pandemic.
  • Kiwamu Noshiro, Takeshi Umazume, Rifumi Hattori, Soromon Kataoka, Takashi Yamada, Hidemichi Watari
    Nutrients 14 9 2022年05月09日 
    Among the physiological changes occurring during pregnancy, the benefits of morning sickness, which is likely mediated by human chorionic gonadotropin (HCG) and induces serum ketone production, are unclear. We investigated the relationship between serum levels of ketone bodies and HCG in the first, second, and third trimesters and neonatal body shape (i.e., birth weight, length, head circumference, and chest circumference) in 245 pregnant women. Serum levels of 3-hydroxybutyric acid peaked in late-stage compared with early stage pregnancy (27.8 [5.0-821] vs. 42.2 [5.0-1420] μmol/L, median [range], p < 0.001). However, serum levels of ketone bodies and HCG did not correlate with neonatal body shape. When weight loss during pregnancy was used as an index of morning sickness, a higher pre-pregnancy body mass index was associated with greater weight loss. This study is the first to show that serum ketone body levels are maximal in the third trimester of pregnancy. As the elevation of serum ketone bodies in the third trimester is a physiological change, high serum levels of ketone bodies may be beneficial for mothers and children. One of the possible biological benefits of morning sickness is the prevention of diseases that have an increased incidence due to weight gain during pregnancy.
  • Keren Cheng, Yasunari Seita, Taku Moriwaki, Kiwamu Noshiro, Yuka Sakata, Young Sun Hwang, Toshihiko Torigoe, Mitinori Saitou, Hideaki Tsuchiya, Chizuru Iwatani, Masayoshi Hosaka, Toshihiro Ohkouchi, Hidemichi Watari, Takeshi Umazume, Kotaro Sasaki
    Science advances 8 16 eabn8485  2022年04月22日 
    Development of the adrenal cortex, a vital endocrine organ, originates in the adrenogonadal primordium, a common progenitor for both the adrenocortical and gonadal lineages in rodents. In contrast, we find that in humans and cynomolgus monkeys, the adrenocortical lineage originates in a temporally and spatially distinct fashion from the gonadal lineage, arising earlier and more anteriorly within the coelomic epithelium. The adrenal primordium arises from adrenogenic coelomic epithelium via an epithelial-to-mesenchymal transition, which then progresses into the steroidogenic fetal zone via both direct and indirect routes. Notably, we find that adrenocortical and gonadal lineages exhibit distinct HOX codes, suggesting distinct anterior-posterior regionalization. Together, our assessment of the early divergence of these lineages provides a molecular framework for understanding human adrenal and gonadal disorders.
  • Masayuki Sekine, Koji Nishijima, Satoshi Nakagawa, Yukio Suzuki, Takashi Murakami, Yasuhito Kato, Takeshi Umazume, Hiroaki Tanaka, Hiroaki Komatsu, Koutaro Doi, Kiyonori Miura, Yoshiki Kudo, Nobuya Unno, Tadashi Kimura, Takayuki Enomoto
    The journal of obstetrics and gynaecology research 2022年04月06日 
    AIM: We aimed to grasp the actual working hours of Japanese obstetricians and gynecologists (OB/GYN doctors) as accurately as possible, using the same method of the Ministry of Health, Labour, and Welfare (MHLW). METHODS: The time study targeted OB/GYN doctors working at 10 universities nationwide including Niigata University and 21 institutions which take a role of perinatal care in Niigata prefecture. Working hours per week were calculated based on the following categories: regular and overtime work inside the hospital, work outside the hospital, self-improvement, education, research, and others. Data on weekly working hours were converted to yearly data for analyses. RESULTS: A time study of 10 universities nationwide revealed that 30% of doctors work overtime for more than 1860 h even if they do not include on-call shifts in their working hours. In 21 institutions in Niigata, physicians in Niigata University worked more overtime than other hospitals. It became clear that community health care was supported by dispatching physicians working at university. Furthermore, the results of simulations predicted the pessimistic situation of perinatal medical care in Niigata. CONCLUSIONS: Our study showed the possibility to exist much more OB/GYN doctors who work more than 1860 h of overtime work per year than the data presented by the MHLW based on nation-wide survey in 2019. The fact that the working hours at the side jobs had a great influence on the increase in overtime work of physicians in University was the same result as the report of MHLW published in 2021.
  • Mamoru Morikawa, Masahiro Ieko, Kinuko Nakagawa-Akabane, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Michinori Mayama, Yoshihiro Saito, Hidemichi Watari
    International journal of hematology 2022年03月22日 
    BACKGROUND: The best thromboprophylaxis for pregnant women with congenital antithrombin deficiency (CAD) is controversial. OBJECTIVE: To clarify the effectiveness of a protocol for venous thromboembolism (VTE) prevention in pregnant women with CAD. METHODS: Women at high risk of VTE were administered antithrombin concentrate and heparin after conception, whereas those at low risk of VTE were administered heparin alone until delivery. All women received antithrombin concentrate at delivery except for one who was diagnosed with CAD. RESULTS: Ten women had CAD, including one in the high-risk group and nine in the low-risk group. No women had VTE at delivery as per the protocol for VTE prevention. Almost all women had increased antithrombin activity before delivery followed by maintenance at ≥ 70% due to antithrombin concentrate administration. VTE prophylaxis during and after delivery was successful in all women with CAD. However, one woman in the low-risk group did not receive heparin and developed VTE induced by severe hyperemesis at 9 gestational weeks, before the diagnosis of CAD. Women in the high-risk group received antithrombin concentrate after delivery but had increased D-dimer levels at postpartum. CONCLUSIONS: Our protocol to prevent VTE in pregnant women with CAD is safe and effective.
  • Kiwamu Noshiro, Takeshi Umazume, Rifumi Hattori, Soromon Kataoka, Takashi Yamada, Hidemichi Watari
    Nutrients 14 4 2022年02月17日 
    It is undetermined which blood variables related to iron storage during the first trimester of pregnancy could efficiently predict anemia occurring during the third trimester. Red blood cell count (RBC), hemoglobin concentration, hematocrit, ferritin, iron, and total iron binding capacity (TIBC) were assessed longitudinally during the first, second, and third trimesters of 231 healthy Japanese women. None of the patients had anemia in the first trimester and none used iron supplementation before the second trimester blood test. Anemia was defined as hemoglobin (Hb) < 11 g/dL for the first trimester and Hb < 10.0 g/dL for the third trimester. Forty-seven (20%) women developed anemia in the third trimester. The first trimester RBC, Hb, hematocrit, and ferritin levels were significantly lower in women with third-trimester anemia than those without anemia. The first trimester hemoglobin level exhibited a greater area under the curve of the receiver operating characteristic curve for prediction of the third trimester anemia than other blood variables; the optimal cut-off (12.6 g/dL) of hemoglobin yielded a sensitivity of 83% (39/47). First trimester hemoglobin levels were significantly better predictors of anemia during the third trimester than the indices of iron storage, including serum iron, ferritin, and TIBC levels.
  • Yoshihiro Saito, Sumitaka Kobayashi, Atsuko Ikeda‐Araki, Sachiko Ito, Chihiro Miyashita, Takashi Kimura, Takumi Hirata, Akiko Tamakoshi, Michinori Mayama, Kiwamu Noshiro, Kinuko Nakagawa, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Mamoru Morikawa, Kazutoshi Cho, Hidemichi Watari, Yoshiya Ito, Yasuaki Saijo, Reiko Kishi, Michihiro Kamijima, Shin Yamazaki, Yukihiro Ohya, Reiko Kishi, Nobuo Yaegashi, Koichi Hashimoto, Chisato Mori, Shuichi Ito, Zentaro Yamagata, Hidekuni Inadera, Takeo Nakayama, Hiroyasu Iso, Masayuki Shima, Youichi Kurozawa, Narufumi Suganuma, Koichi Kusuhara, Takahiko Katoh
    Journal of Diabetes Investigation 2021年12月22日
  • Ryosuke Shindo, Shigeru Aoki, Toshihiro Misumi, Sayuri Nakanishi, Takeshi Umazume, Takeshi Nagamatsu, Hisashi Masuyama, Atsuo Itakura, Tomoaki Ikeda
    The journal of obstetrics and gynaecology research 2021年10月07日 
    AIM: In Japan, the criteria of the latent and active phases of the first stage of labor have not been decided. The Japan Society of Obstetrics and Gynecology (JSOG) Perinatal Committee conducted a study to construct a spontaneous labor curve in order to determine the point of onset of the active phase. METHODS: The participants were women who had spontaneous deliveries at four health facilities in Japan between September 1, 2011, and September 31, 2019. Spontaneous delivery was defined as the spontaneous onset of labor at term (37 weeks, 0 days to 41 weeks, 6 days) with vaginal delivery of a mature fetus in a cephalic position without uterotonic agents or epidural analgesia. The time points for each "cm" of dilation were collected starting from the time of full dilation retrogradely. The relationship between time since labor onset and cervical dilation was expressed as a curve using a smoothing B-spline. RESULTS: A total of 4215 primiparous and 5266 multiparous women were included in this study. The spontaneous labor curve showed that in both primiparous and multiparous women, labor progress was slow until 5 cm cervical dilation, accelerating between 5 and 6 cm dilation, and steadily progressed after 6 cm dilation. CONCLUSION: We propose that the active phase of the first stage of labor be defined as starting at 5 cm dilation of the cervix, and that it be divided into an acceleration phase (5-6 cm dilation) and a maximal phase (>6 cm dilation).
  • Mamoru Morikawa, Yoshihiro Saito, Michinori Mayama, Kiwamu Noshiro, Kinuko Nakagawa-Akabane, Takeshi Umazume, Kentaro Chiba, Hidemichi Watari
    The journal of obstetrics and gynaecology research 47 10 3498 - 3508 2021年10月 
    AIM: To investigate the relationship between excessive gestational weight gain during the week prior to delivery (GWG) and severe morbidity and pregnancy termination among pregnant women with preeclampsia (hypertension with proteinuria). METHODS: We compared GWG, laboratory data, and complication(s) between 94 preeclamptic women (preeclampsia group) with singleton pregnancies who delivered at ≥22 gestational weeks and 188 healthy women (control group) with singleton pregnancies undergoing elective cesarean deliveries. The gestational weeks at delivery were matched in the preeclampsia and control groups. RESULTS: Among 282 total participants, median of GWG was significantly higher in the preeclampsia group than in the control group (1.6 kg vs. 0.5 kg, p < 0.0001). Furthermore, the GWG cutoff value for the preeclampsia group was 1.6 kg. The odds ratio for morbidity of preeclampsia among the women with GWG ≥1.6 kg at delivery was 12.5 (95% confidence interval, 6.31-24.5). In the preeclampsia group, 47 women with GWG ≥1.6 kg had significantly higher risks of hypoproteinemia, proteinuria, and renal dysfunction than those of 47 women with GWG < 1.6 kg. While, multivariate analysis showed 1.5 kg was a GWG cutoff value for predicting maternal morbidity (p < 0.0001); preeclamptic women with GWG ≥1.5 kg had a significantly higher risk of pulmonary edema than preeclamptic women with GWG < 1.5 kg (odds ratio, 7.77; 95% confidence interval, 1.64-36.7). CONCLUSION: Excessive GWG in women with preeclampsia might be a predictor for severe maternal life-threatening complications requiring pregnancy termination.
  • Soichiro Obata, Etsuko Miyagi, Yasuo Haruyama, Takeshi Umazume, Gen Kobashi, Asuka Yoshimi, Akitoyo Hishimoto, Kentaro Kurasawa, Yukio Suzuki, Tomoaki Ikeda, Tadashi Kimura, Hideto Yamada
    The journal of obstetrics and gynaecology research 47 9 2990 - 3000 2021年09月 
    AIM: To evaluate psychological stress among pregnant and puerperal women in Japan during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this cross-sectional study, we recruited pregnant women and puerperal women who delivered between January and September 2020 in Japan, using an online questionnaire. Participants were divided into low, middle, and high groups according to the degree of the epidemic in their region of residence. Related factors were analyzed using the chi-squared test. The relationship between COVID-19 epidemic regions and depression risks and anxiety using the Edinburgh Postnatal Depression Scale (EPDS) and Kessler 6 scale (K6) was evaluated using a univariate and multivariable logistic regression model. RESULTS: Overall, 7775 cases, including 4798 pregnant and 2977 puerperal women, were analyzed. The prevalence of high EPDS and K6 scores was significantly increased in pregnant women in the high than those in the low epidemic regions (EPDS: adjusted odds ratio [aOR] 1.453, 95% confidence interval [CI] 1.205-1.753; K6: aOR 1.601, 95% CI 1.338-1.918). There was no difference in EPDS score, but the prevalence of high K6 scores was significantly increased in puerperal women in the high than those in the low epidemic regions (aOR 1.342, 95% CI 1.066-1.690). Further, restriction on going to their hometown for delivery increased the prevalence of high EPDS scores among pregnant (aOR 1.663, 95% CI 1.296-2.133) and puerperal women (aOR 1.604, 95% CI 1.006-2.557). CONCLUSIONS: Decreased support due to the COVID-19 pandemic affected the psychological status of pregnant and puerperal women; hence, investing medical resources in their healthcare essential.
  • Takeshi Umazume, Etsuko Miyagi, Yasuo Haruyama, Soichiro Obata, Gen Kobashi, Kentaro Kurasawa, Yukio Suzuki, Tomoaki Ikeda, Tadashi Kimura, Hideto Yamada
    The journal of obstetrics and gynaecology research 47 9 3001 - 3007 2021年09月 
    AIM: The aim of this study was to clarify the physical and mental burden of the COIVD-19 pandemic on obstetricians and gynecologists in Japan and to identify factors that increase the burden of their psychological stress. METHODS: A web-based questionnaire was sent to obstetricians and gynecologists in Japan via email and social media to collect voluntary responses. This survey was conducted from September 1 to 30, 2020. RESULTS: A total of 852 valid responses were included in the analysis; 76% (644) of the physicians felt that the COVID-19 pandemic caused them physical and mental stress equal to or greater than the most severe disaster they had ever experienced. Physicians who reported high mental and physical stress were more likely to be in areas with high numbers of infected patients (odds ratio (OR) 1.571, p = 0.012). Physicians experienced great stress to the point of wearing heavy personal protective equipment during routine vaginal deliveries by mothers with no COVID-19 symptoms. This trend was markedly pronounced for physicians working in regions with fewer cases of COVID-19 infection. CONCLUSIONS: Obstetricians and gynecologists who reported high mental and physical stress were more likely to be in areas with high numbers of infected patients. One potential reason for this may be that they were required to wear more personal protective equipment than necessary. Infection control methods that ensure the safety of obstetricians and gynecologists while not causing unnecessary physical or psychological stress are needed.
  • Kinuko Nakagawa, Takeshi Umazume, Michinori Mayama, Kentaro Chiba, Yoshihiro Saito, Kiwamu Noshiro, Mamoru Morikawa, Masanori Yoshino, Hidemichi Watari
    The journal of obstetrics and gynaecology research 47 7 2380 - 2386 2021年07月 
    AIM: Perinatal telemedicine efforts have commenced worldwide in response to the COVID-19 pandemic. As there have been no prior studies on the acceptance of telemedicine by pregnant women, we conducted this survey to investigate the same. METHODS: We conducted an anonymous questionnaire survey of pregnant women who underwent telemedicine check-ups from March 4 to June 30, 2020, using a mobile fetal heart rate monitor and video call system through the Hokkaido University Hospital. RESULTS: Out of the 77 individuals who received prenatal telemedicine check-ups, 54 individuals (70%) had complications, and 64 individuals (83%) consented for the questionnaire survey. In the video call system, 18 individuals (28%) were found to be unwell and 17 individuals (27%) experienced difficulty using the mobile fetal heart rate monitoring device. Assuming scores for face-to-face consultations were five out of 10, the mean score for satisfaction was 4.2, but 19 (30%) women felt equal or greater satisfaction with face-to-face consultations. If not for the threat of COVID-19, only four individuals (6%) proactively expressed a desire for telemedicine, with a significantly less demand observed among primiparous women than multiparous women. The permissible additional financial burden enabling telemedicine was $10 or less for 80% of subjects. CONCLUSION: In this small preliminary study, 30% of the pregnant women felt equal or greater satisfaction with telemedicine than face-to-face consultations. A stronger demand for telemedicine was exhibited by multiparous women than primiparous women. Thus, a system that would be advantages by limiting subjects and enabling low-cost examinations is required for making perinatal telemedicine more popular.
  • Mamoru Morikawa, Michinori Mayama, Kiwamu Noshiro, Yoshihiro Saito, Kinuko Nakagawa-Akabane, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Hidemichi Watari
    Scientific reports 11 1 12708 - 12708 2021年06月16日 
    Although gestational hypertension (GH) is a well-known disorder, gestational proteinuria (GP) has been far less emphasized. According to international criteria, hypertensive disorders of pregnancy include GH but not GP. Previous studies have not revealed the predictors of progression from GP to preeclampsia or those of progression from GH to preeclampsia. We aimed to determine both sets of predictors. A retrospective cohort study was conducted with singleton pregnant women who delivered at 22 gestational weeks or later. Preeclampsia was divided into three types: new onset of hypertension/proteinuria at 20 gestational weeks or later and additional new onset of other symptoms at < 7 days or at ≥ 7 days later. Of 94 women with preeclampsia, 20 exhibited proteinuria before preeclampsia, 14 experienced hypertension before preeclampsia, and 60 exhibited simultaneous new onset of both hypertension and proteinuria before preeclampsia; the outcomes of all types were similar. Of 34 women with presumptive GP, 58.8% developed preeclampsia; this proportion was significantly higher than that of 89 women with presumptive GH who developed preeclampsia (15.7%). According to multivariate logistic regression models, earlier onset of hypertension/proteinuria (before or at 34.7/33.9 gestational weeks) was a predicator for progression from presumptive GH/GP to preeclampsia (odds ratios: 1.21/1.21, P value: 0.0044/0.0477, respectively).
  • 妊娠中の貧血予測に関する検討
    能代 究, 馬詰 武, 良川 大晃, 眞山 学徳, 齊藤 良玄, 中川 絹子, 千葉 健太郎, 森川 守, 渡利 英道
    日本周産期・新生児医学会雑誌 57 Suppl. P154 - P154 (一社)日本周産期・新生児医学会 2021年06月
  • 硝酸薬を用いて急性妊娠性脂肪肝の術後管理をおこなった1例
    齊藤 良玄, 櫻井 愛美, 良川 大晃, 能代 究, 眞山 学徳, 中川 絹子, 馬詰 武, 千葉 健太郎, 森川 守, 渡利 英道
    日本周産期・新生児医学会雑誌 57 Suppl. P219 - P219 (一社)日本周産期・新生児医学会 2021年06月
  • 新型コロナウィルス流行下における新たな医学教育方法
    千葉 健太郎, 能代 究, 眞山 学徳, 齋藤 良玄, 中川 絹子, 馬詰 武, 河口 哲, 森川 守, 渡利 英道
    日本周産期・新生児医学会雑誌 57 Suppl. P331 - P331 (一社)日本周産期・新生児医学会 2021年06月
  • Mamoru Morikawa, Takashi Yamada, Yoshihiro Saito, Kiwamu Noshiro, Michinori Mayama, Kinuko Nakagawa-Akabane, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Hidemichi Watari
    The journal of obstetrics and gynaecology research 47 4 1292 - 1304 2021年04月 
    AIM: To clarify whether maternal characteristics or laboratory parameters could help predict the onset of recurrent gestational diabetes mellitus (GDM). METHODS: We enrolled 615 women with consecutive singleton deliveries at or after 28 GW from two perinatal medical centers between 2011 and 2019 and divided them into four groups according to whether they had GDM in the first and second pregnancies. The outcome of this study was to clarify the incidence and the predictors of recurrent GDM. RESULTS: We found that among 72 women (11.7%) who had GDM during their first pregnancy, the rate of recurrent GDM was 47.2%. The 34 women (5.5%) with recurrent GDM gained significantly less weight in the first and second pregnancies and lost less weight between the first delivery and the second conception compared with those women without GDM in both pregnancies. Of women with GDM during the first pregnancy, 21 scored 2 or 3 (multiple) positive points on a 75-g oral glucose tolerance test (OGTT) during their first pregnancies; the GDM recurrence rate among these women (66.7%) was significantly higher than that among the 51 women who scored 1 positive point (39.2%; p = 0.0411). During the first pregnancy, insulin administration therapy was significantly more frequent in women with recurrent GDM than in women without recurrent GDM (23.5% vs. 5.3%, p = 0.0396, respectively). CONCLUSION: A predictor of recurrent GDM onset was a score of 2 or 3 positive points on the OGTT during the first pregnancy.
  • 妊娠中に経腹的子宮頸管縫術を施行した1例
    中陳 哲也, 良川 大晃, 能代 究, 眞山 学徳, 齊藤 良玄, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本産科婦人科学会雑誌 73 臨増 S - 358 (公社)日本産科婦人科学会 2021年03月
  • 妊娠中のケトン体の推移と妊娠経過への影響に関する検討
    能代 究, 馬詰 武, 良川 大晃, 中陳 哲也, 眞山 学徳, 齊藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本産科婦人科学会雑誌 73 臨増 S - 383 (公社)日本産科婦人科学会 2021年03月
  • SARS-CoV-2 PCR検査陽性および濃厚接触者妊婦への対応に苦慮した3例
    良川 大晃, 馬詰 武, 中陳 哲也, 能代 究, 眞山 学徳, 齊藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本産科婦人科学会雑誌 73 臨増 S - 548 (公社)日本産科婦人科学会 2021年03月
  • Michinori Mayama, Mamoru Morikawa, Takashi Yamada, Takeshi Umazume, Kiwamu Noshiro, Kinuko Nakagawa, Yoshihiro Saito, Kentaro Chiba, Satoshi Kawaguchi, Hidemichi Watari
    BMC pregnancy and childbirth 21 1 91 - 91 2021年01月28日 
    BACKGROUND: Currently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of < 100 × 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of < 150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count < 150 × 109/L and ≥ 100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. METHODS: A total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥ 150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥ 100 × 109/L; and severe thrombocytopenia, < 100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. RESULTS: Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59-7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06-2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06-1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41-2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62-1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76-1.24] for neonatal intensive care unit admission. CONCLUSIONS: Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.
  • Takeshi Umazume, Takahiro Yamada, Itsuko Furuta, Hiroyuki Iwano, Mamoru Morikawa, Hidemichi Watari, Hisanori Minakami
    BMC pregnancy and childbirth 20 1 750 - 750 2020年12月02日 
    BACKGROUND: This study aimed to compare the echocardiographic changes and cardiac biomarkers between women with singleton and twin pregnancies. METHODS: From April 2014 to March 2016, this longitudinal cohort study invited pregnant women who were scheduled to give birth at Hokkaido University Hospital. We analyzed prospectively collected data on simultaneously determined echocardiographic parameters and blood cardiac markers of 44 women with singleton and 22 women with twin pregnancies. Furthermore, we tested the mixed-effect models for echocardiographic parameters and cardiac biomarkers. RESULTS: During the third trimester and immediately postpartum (within 1 week after childbirth), the mean left atrial volume index and brain natriuretic peptide (BNP) level were significantly higher in women with twin pregnancies than in those with singleton pregnancies. Women with twin pregnancies also had significantly smaller second-trimester inferior vena cava diameters and significantly higher third-trimester creatinine levels than those with singleton pregnancies. BNP positively correlated with the left atrial volume index (β = 0.49, p < 0.01) and the ratio of early diastolic transmitral to mitral annular velocity (E/e') (β = 0.41, p < 0.01). At 1 month after childbirth in women with singleton pregnancies, BNP and N-terminal precursor protein BNP (NT-proBNP) fragments immediately postpartum negatively correlated with the later E/e' (r = - 0.33, p = 0.02 and r = - 0.36, p < 0.01, respectively). CONCLUSIONS: The intravascular cardiac load reached maximum within 1 week after childbirth and was greater in women with twin pregnancies than in those with singleton pregnancies. BNP/NT-proBNP significantly positively correlated with LA volume index and E/e'. In women with singleton pregnancies, BNP secreted immediately after childbirth might improve the diastolic functions 1 month after childbirth.
  • 2D-speckle tracking法による胎児循環から新生児循環への移行に伴う心機能の変化
    眞山 学徳, 馬詰 武, 齊藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    超音波医学 47 Suppl. S394 - S394 (公社)日本超音波医学会 2020年11月
  • Takeshi Umazume, Etsuko Miyagi, Yasuo Haruyama, Gen Kobashi, Shigeru Saito, Satoshi Hayakawa, Kei Kawana, Satoru Ikenoue, Ichiro Morioka, Hideto Yamada
    The journal of obstetrics and gynaecology research 46 10 1933 - 1939 2020年08月10日 [査読有り][通常論文]
     
    AIM: To clarify the status of personal protective equipment (PPE) and coronavirus disease 2019 (COVID-19) tests for pregnant women, we conducted an urgent survey. METHODS: The survey was conducted online from April 27 to May 1, 2020. Questionnaires were sent to core facilities and affiliated hospitals of the obstetrics and gynecology training program and to hospitals of the national perinatal medical liaison council. RESULTS: A total of 296 institutions participated in our survey; however, 2 institutions were excluded. Full PPE was used by doctors in 7.1% of facilities and by midwives in 6.8%. Our study also determined that around 65.0% of facilities for doctors and 73.5% of facilities for midwives used PPE beyond the "standard gown or apron, surgical mask, goggles or face shield" during labor of asymptomatic women. N95 masks were running out of stock at 6.5% of the facilities and goggles and face shields at 2.7%. Disposable N95 masks and goggles or face shields were re-used after re-sterilization in 12% and 14% of facilities, respectively. Polymerase chain reaction (PCR) testing of asymptomatic patients was performed for 9% of vaginal deliveries, 14% of planned cesarean sections and 17% of emergency cesarean sections. The number of PCR tests for obstetrics and gynecology per a week ranged from zero to five in 92% of facilities. CONCLUSION: The shortage of PPE in Japan is alarming. Sufficient stockpiling of PPE is necessary to prevent unnecessary disruptions in medical care. Appropriate guidelines for PPE usage and COVID-19 testing of pregnant women at delivery are needed in Japan.
  • Kinuko Nakagawa, Takeshi Umazume, Michinori Mayama, Kentaro Chiba, Yoshihiro Saito, Satoshi Kawaguchi, Mamoru Morikawa, Masanori Yoshino, Hidemichi Watari
    The journal of obstetrics and gynaecology research 2020年07月20日 [査読有り][通常論文]
     
    AIM: In Hokkaido, Japan, the number of people suffering from coronavirus disease 2019 (COVID-19) is rapidly increased, and by the end of February 2020, there were already 70 confirmed cases of the disease. We investigated the safety of urgently initiated maternal telemedicine in preventing the spread of the coronavirus infection. METHODS: This retrospective, single-institution study examined maternal telemedicine at the department of obstetrics of the Hokkaido University Hospital from March 4 to April 2, 2020. The physicians remotely examined the pregnant women from their homes using a visual communication system which kept communication confidential, performed prenatal checkup and administered medical care according to their various blood pressures, weights and cardiotocograms. RESULTS: Forty-four pregnant women received a total of 67 telemedicine interventions. Thirty-two pregnant women (73%) had complications, and 22 were primiparas (50%). Telemedicine interventions were provided 19 times at less than 26 weeks of gestation, 43 times between 26 and 36 weeks of gestation and 5 times after 37 weeks of gestation. There was one case with an abnormality diagnosed during the remote prenatal checkups, and the patient was hospitalized on the same day. However, there were no abnormal findings observed in mothers and children during the other 66 remote prenatal checkups and medical care. CONCLUSION: Maternal telemedicine can be safely conducted in pregnant women who are at risk of having an underlying disorder or fetal abnormality 1 month following the start of the attempt. It should be considered as a form of maternal medical care to prevent the spread of COVID-19.
  • Mamoru Morikawa, Michinori Mayama, Yoshihiro Saito, Kinuko Akabane-Nakagawa, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Kazutoshi Cho, Hidemichi Watari
    Pregnancy hypertension 21 111 - 117 2020年07月 [査読有り][通常論文]
     
    OBJECTIVES: To investigate the relationship between serum total protein (TP) levels and maternal/neonatal outcomes among pregnant women with preeclampsia. STUDY DESIGN: TP was measured at preeclampsia diagnosis and delivery in 94 women with singleton pregnancies and preeclampsia as hypertension with proteinuria who delivered at ≥ 22 gestational weeks (GWs). As a control group, measurements were also made in 188 women with singleton pregnancies without hypertension and/or proteinuria. MAIN OUTCOME MEASURES: The relationship between serum TP levels and maternal outcomes. RESULTS: Serum TP levels showed a significantly negative relationship with urine protein-to-creatinine (P/C) ratio at preeclampsia diagnosis and delivery. Serum TP levels at delivery in the preeclampsia group (53 ± 7 g/L) were lower than in the control group (61 ± 4 g/L, P < 0.0001). In each group, there was no relationship between the daily decrease in TP and the daily increase maternal body weight. However, there was a positive relationship between the daily increase in P/C ratio and the daily increase in maternal body weight in the preeclampsia group (P = 0.0021). Severe hypoproteinemia at preeclampsia diagnosis was a predictor of abruptio placentae (TP < 49 g/L; odds ratio, 21.3) and peripartum cardiomyopathy (TP < 45 g/L; odds ratio, 43.5). Furthermore, women with severe hypoproteinemia at delivery had higher morbidity due to pulmonary edema (TP < 55 g/L; odds ratio, 26.4) and central serous chorioretinopathy (TP < 42 g/L; odds ratio, 264). CONCLUSIONS: Serum TP levels and proteinuria severity at preeclampsia diagnosis and delivery showed a positive relationship and predicted poor maternal outcome.
  • 尿中Placental growth factorによる妊娠高血圧腎症の発症予知
    古田 伊都子, 馬詰 武, 森川 守, 渡利 英道, 水上 尚典
    日本産科婦人科学会雑誌 72 臨増 S - 384 (公社)日本産科婦人科学会 2020年03月
  • Attenuation Imagingを用いた新しい胎盤評価法
    赤羽 慧一郎, 馬詰 武, 安藤 里沙, 眞山 学徳, 齊藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本産科婦人科学会雑誌 72 臨増 S - 555 (公社)日本産科婦人科学会 2020年03月
  • Michinori Mayama, Takeshi Umazume, Hidemichi Watari, Sho Nishiguchi, Takuhiro Moromizato, Takashi Watari
    JOURNAL OF OCCUPATIONAL HEALTH 62 1 2020年01月 
    ObjectivesIn Japan, the prevalence of irregular menstrual cycles and its association with the frequency of night shifts have scarcely assessed. The present study aimed to evaluate the relationship between irregular menstrual cycles and the frequency of night shifts in Japanese female nurses.MethodsWe conducted a cross-sectional web-based self-administered questionnaire survey in 2019. An irregular menstrual cycle was defined as a cycle length of <= 21 days or >= 39 days at least a few times over the past year or amenorrhea for at least 3 months. We used Poison regression analysis with a robust error variance to calculate the prevalence ratios adjusted for age, body mass index, hospital size, and the department in which they worked.ResultsA total of 1249 women were included, and 679 (54.4%) and 195 (15.6%) of them worked under two and three rotating shifts. The prevalence of irregular menstrual cycles was 24.8%, 37.4%, and 35.9% in the no night, two rotating, and three rotating shifts groups, respectively. While the frequency of night shifts had a dose-responsive relationship with irregular menstrual cycles in the two rotating shifts group, it was not observed in the three rotating shifts group. However, the risk of work getting affected by dysmenorrhea or premenstrual symptoms increased in the three rotating shifts group.ConclusionsOver 30% of Japanese female nurses working under night shifts had irregular menstrual cycles. The high frequency of night shifts increased the risk of irregular menstrual cycles and secondary amenorrhea in the two rotating shifts group.
  • Mamoru Morikawa, Michinori Mayama, Yoshihiro Saito, Kinuko Nakagawa-Akabane, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Kazutoshi Cho, Hidemichi Watari
    Pregnancy hypertension 19 119 - 126 2020年01月 [査読有り][通常論文]
     
    OBJECTIVES: The present study aimed to determine the relationship between the severity of proteinuria and maternal/neonatal outcomes among women with preeclampsia. STUDY DESIGN: Proteinuria severity was measured at preeclampsia diagnosis and at delivery in 94 women with preeclampsia (among 2904 women with singleton pregnancies, who delivered after 22 gestational weeks). Preeclampsia was defined as hypertension with proteinuria. MAIN OUTCOME MEASURES: Protein:creatinine (P/C) ratio to worse the maternal outcome was 4.8 among women with preeclampsia. RESULTS: The frequencies of HELLP syndrome and maternal pulmonary edema in women with a P/C ratio ≥5.0 (35.5% and 35.5%, respectively) were significantly higher than those in women with a P/C ratio <5.0 (12.7%, P = 0.014 and 6.4%, P < 0.001, respectively). The best P/C ratio cutoff value to determine early-onset preeclampsia and early preterm birth (EPB) was 4.1 (P < 0.001 and P < 0.001, respectively). The best P/C ratio cutoff values to determine the interval between the preeclampsia diagnosis and delivery <7 days and the need to undergo cesarean section were 1.8 and 1.5, respectively. The best P/C ratio cutoff value to determine maternal pulmonary edema and central serous chorioretinopathy (CSC) was 4.8 (P = 0.020 and P = 0.014, respectively). Finally, the best P/C ratio cutoff values to determine EPB and maternal CSC in women with preeclampsia were 4.1 (odds ratio, 10.9; 95% confidence interval; 4.08 to 29.2, P < 0.0001) and 4.8 (odds ratio, 17.6; 95% confidence interval; 0.898 to 344, P = 0.0008), respectively, according to the multivariate analysis. CONCLUSIONS: A higher P/C ratio at delivery in women with preeclampsia might cause EPB and CSC.
  • Mamoru Morikawa, Emi Kato-Hirayama, Michinori Mayama, Yoshihiro Saito, Kinuko Nakagawa, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Kazuhiko Okuyama, Hidemichi Watari
    PloS one 15 3 e0230488  2020年 [査読有り][通常論文]
     
    Pregnant women with diabetes mellitus (DM) are at high risk for hypertensive disorder of pregnancy (HDP). Women with poor control DM sometimes have heavy-for-dates infants. However, women with HDP sometimes have light-for-dates infants. We aim to clarify the relationship between glycemic control and fetal growth in women with DM and/or subsequent HDP. Of 7893 women gave singleton birth at or after 22 gestational weeks, we enrolled 154 women with type 1 DM (T1DM) or type 2 DM (T2DM) whose infants did not have fetal abnormalities. Among women with T1DM or T2DM, characteristics of the three groups (with HDP, without HDP, and with chronic hypertension [CH]) were compared. No women with T1DM had CH, but 19 (17.4%) of 109 with T2DM did. HDP incidence was similar between women with T1DM (22.2%) and T2DM without CH (16.7%). Among women with T1DM, the incidences of fetal growth restriction (FGR) with and without HDP were similar. However, among women with T2DM without CH, this incidence was significantly higher among those with HDP (33.3%) than among those without HDP (5.3%), was significantly more common with HbA1c levels at first trimester ≥ 7.2% (33.3%) than with those < 7.2% (5.6%), and significantly more numerous without pre-pregnancy therapies for DM (23.3%) than with them (3.3%). Among women with T2DM and HDP, those with FGR had smaller placenta SDs and higher insulin dosages at delivery than those without light-for-dates. In multivariate analysis, the presence of diabetic nephropathy was a predictor of T1DM and HDP (P = 0.0105), whereas HbA1c levels ≥ 7.2% before pregnancy was a predictor of T2DM and HDP (P = 0.0009). Insulin dosage ≥ 50U/day at delivery (P = 0.0297) and the presence of HDP (P = 0.0116) independently predicted T2DM, HDP, and FGR development. Insufficient pre-pregnancy treatment of DM increased the risk of HDP.
  • Mamoru Morikawa, Takeshi Umazume, Kinuko Nakagawa, Kentaro Chiba, Satoshi Kawaguchi, Hidemichi Watari
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 147 3 375 - 381 2019年12月 [査読有り][通常論文]
     
    OBJECTIVE: To examine whether laboratory parameters can predict the onset of recurrent hypertensive disorders of pregnancy (HDP). METHODS: A retrospective study of 257 women with consecutive deliveries at a hospital in Sapporo, Japan, between 2009 and 2017. Women were divided into four groups according to whether or not they had HDP in the first and second peripartum periods (HDP-HPD, HDP-Non, Non-HDP, Non-Non). HDP was defined as gestational hypertension and/or proteinuria. Laboratory parameters measured on the day of or 1 day before delivery were compared between peripartum-1 and peripartum-2. RESULTS: Frequency of HDP in peripartum-2 was higher among the 24 (9.3%) women with HPD in peripartum-1 (6/24, 25.0%) than among the 233 (90.7%) women without (3/233, 1.3%) (P<0.001). In peripartum-1, women with HDP had lower median antithrombin activity than those without (74% vs 89%, P=0.021). Antithrombin activity in peripartum-1 was also lower in the HDP-HDP (67%) than in the HDP-Non (79%) group (P=0.021). Antithrombin activities of 77% or less at the first delivery predicted HDP in peripartum-1 (P<0.001) and 70% or less predicted HDP in peripartum-2 (P=0.018). CONCLUSION: Women with HDP in peripartum-1 had a higher incidence of HDP recurrence. Low antithrombin before a first delivery might predict recurrent HDP in a second pregnancy.
  • 眞山 学徳, 秋江 惟能, 今泉 翠, 斎藤 良玄, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本妊娠高血圧学会雑誌 26 52 - 52 (一社)日本妊娠高血圧学会 2019年09月
  • 森川 守, 平山 恵美, 眞山 学徳, 中川 絹子, 千葉 健太郎, 馬詰 武, 河口 哲, 奥山 和彦, 渡利 英道
    日本妊娠高血圧学会雑誌 26 59 - 59 (一社)日本妊娠高血圧学会 2019年09月
  • 産後の心不全を予測して対応したものの周産期心筋症の発症に至った一例 心筋トロポニンIの活用
    高桑 佑佳, 馬詰 武, 眞山 学徳, 齋藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 67回 50 - 50 東北連合産科婦人科学会・北日本産科婦人科学会 2019年09月
  • HELLP症候群、周産期心筋症と急性腎不全を併発した搬送妊婦に速やかな心後負荷除去が著効した一例
    松井 優祐, 馬詰 武, 眞山 学徳, 齋藤 良玄, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 67回 50 - 50 東北連合産科婦人科学会・北日本産科婦人科学会 2019年09月
  • 下大静脈フィルター抜去困難にて開腹手術が必要となった産褥期卵巣静脈血栓症の一例
    秋江 惟能, 眞山 学徳, 細川 亜美, 山口 正博, 中川 絹子, 千葉 健太郎, 馬詰 武, 河口 哲, 森川 守, 渡利 英道, 中郷 賢二郎
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 67回 53 - 53 東北連合産科婦人科学会・北日本産科婦人科学会 2019年09月
  • 発作性夜間血色素尿症合併妊娠の1例 HELLP症候群・血栓性血小板減少性紫斑病との鑑別
    赤羽 慧一郎, 秋江 惟能, 奥 聡, 眞山 学徳, 齊藤 良玄, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守, 片岡 宙門, 渡利 英道
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 67回 55 - 55 東北連合産科婦人科学会・北日本産科婦人科学会 2019年09月
  • 眞山 学徳, 細川 亜美, 山口 正博, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守
    日本周産期・新生児医学会雑誌 55 2 662 - 662 (一社)日本周産期・新生児医学会 2019年06月
  • Michinori Mayama, Mamoru Morikawa, Takeshi Umazume, Kinuko Nakagawa, Ami Hosokawa, Masahiro Yamaguchi, Kentaro Chiba, Satoshi Kawaguchi, Hidemichi Watari
    The journal of obstetrics and gynaecology research 45 6 1118 - 1126 2019年06月 [査読有り][通常論文]
     
    AIM: This study aimed to examine how the number of patients diagnosed with pre-eclampsia increased according to the Japanese classification of hypertensive disorders of pregnancy (HDP) that was revised in 2018. The effect of new classification on perinatal outcomes was also analyzed. METHODS: We enrolled 181 women with HDP who delivered at Hokkaido University Hospital between February 2011 and December 2017. All women were reclassified on the basis of the new classification, in which proteinuria was not required to diagnose pre-eclampsia in patients with maternal organ damage. The number and reasons of reclassification and the admission rate to the neonatal intensive care unit (NICU) and gestational age (GA) at the onset of HDP and at delivery were analyzed. RESULTS: In this cohort, 17 (9.4%) of 181 women with HDP were reclassified. Low platelet count (41.2%) and uteroplacental dysfunction (41.2%) were the two main causes for reclassification. GA at the onset of HDP (33.6 [29.9-36.1] weeks vs 37.4 [35.7-38.4] weeks; P < 0.001) and at delivery (35.9 [32.4-37.3] weeks vs 38.1 [37.3-39.6] weeks; P < 0.001) were significantly earlier in women with reclassification than women without reclassification. The NICU admission rate was higher in women with reclassification than women without reclassification (70.6% vs 20.4%; P < 0.001). CONCLUSION: Almost 10% of pregnant women were newly diagnosed with pre-eclampsia as per the new Japanese classification of HDP. Women with reclassification as pre-eclampsia had a greater risk of preterm delivery and NICU admission than those who were not reclassified.
  • Mamoru Morikawa, Takeshi Umazume, Ami Hosokawa-Miyanishi, Hidemichi Watari, Takao Kobayashi, Hiroyuki Seki, Shigeru Saito
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 145 1 62 - 69 2019年04月 [査読有り][通常論文]
     
    OBJECTIVE: To determine the cutoff of antithrombin activity for predicting the interval from diagnosis of early-onset pre-eclampsia to delivery. METHODS: At Hokkaido University Hospital, Japan, data were retrospectively assessed on antithrombin activity measured at both diagnosis of pre-eclampsia and delivery among women with singleton pregnancy and pre-eclampsia (defined by combined gestational hypertension and proteinuria) between 2009 and 2017. The timing of delivery was determined by maternal and fetal well-being. RESULTS: Among 2904 singleton deliveries, antithrombin activity was measured for 94 (3.2%) women diagnosed with pre-eclampsia. The median (range) interval was significantly longer for 38 (40%) women with early-onset than for 56 (60%) women with late-onset pre-eclampsia (6.5 [0-27] vs 1 [0-29] days, respectively; P<0.001). In the early-onset group, median antithrombin activity at diagnosis was significantly lower for 19 women with an interval of less than 7 days (72% [60%-92%]) than for 19 women with a longer interval (≥7 days) (84% [59%-110%]; P=0.012). Antithrombin activity of 78% at diagnosis of early-onset pre-eclampsia was optimal for predicting a delivery interval of less than 7 days. CONCLUSION: A cutoff of 78% antithrombin activity at diagnosis of early-onset pre-eclampsia might be used as a predictor of delivery within 7 days.
  • 当科で出生後にGoldenhar症候群と診断された母児における出生前診断や周産期/新生児予後の特徴
    桑島 一彦, 細川 亜美, 藤枝 聡子, 馬詰 武, 小島 崇史, 河口 哲, 石川 聡司, 長 和俊, 森川 守
    北海道産科婦人科学会会誌 63 1 69 - 69 北海道産科婦人科学会 2019年03月
  • 妊娠高血圧症候群の定義・分類の変更による妊娠高血圧腎症の診断への影響
    眞山 学徳, 山口 正博, 細川 亜美, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本産科婦人科学会雑誌 71 臨増 S - 469 (公社)日本産科婦人科学会 2019年02月
  • 尿中angiogenic factorによる妊娠高血圧腎症の発症予知
    古田 伊都子, 馬詰 武, 森川 守, 渡利 英道, 水上 尚典
    日本産科婦人科学会雑誌 71 臨増 S - 648 (公社)日本産科婦人科学会 2019年02月
  • 早発型妊娠高血圧腎症発症時のアンチトロンビン活性値と妊娠期間延長の関係
    森川 守, 馬詰 武, 細川 亜美, 渡利 英道, 小林 隆夫, 関 博之, 齋藤 滋
    日本産科婦人科学会雑誌 71 臨増 S - 650 (公社)日本産科婦人科学会 2019年02月
  • Mamoru Morikawa, Takashi Yamada, Kinuko Nakagawa, Ami Hosokawa-Miyanishi, Takeshi Umazume, Kentaro Chiba, Satoshi Kawaguchi, Kazutoshi Cho, Hidemichi Watari
    Gynecologic and obstetric investigation 84 5 477 - 484 2019年 [査読有り][通常論文]
     
    AIM: This study was performed to evaluate maternal changes in laboratory characteristics after fetoscopic laser photocoagulation (FLP) for twin-to-twin transfusion syndrome (TTTS). METHODS: A retrospective review was conducted among 30 women with monochorionic diamniotic twin pregnancy with TTTS who underwent FLP at 16-26 weeks of gestation. Maternal laboratory parameters were measured before and after FLP. RESULTS: The pre-FLP mean hemoglobin level (10.0 g/dL), hematocrit level (30.0%), platelet count (229 × 109/mL), fibrinogen level (461 mg/dL), and antithrombin activity (96.8%) decreased after FLP (8.5 g/dL, 25.5%, 204 × 109/mL, 403 mg/dL, and 83.6%, respectively) and returned to normal spontaneously within 2 weeks (9.6 g/dL, 29.4%, 293 × 109/mL, 460 mg/dL, and 102.4%, respectively). The D-dimer level before FLP (2.41 μg/mL) increased after FLP (4.28 μg/mL), and the elevated level was maintained for 2 weeks (3.24 μg/mL). The symptomatic venous thromboembolism (VTE) was not detected after FLP in any of the 30 patients. However, one woman had pulmonary embolism after subsequent cesarean section. CONCLUSION: Changes in maternal anemia and coagulation/fibrinolysis after FLP for TTTS returned to normal spontaneously within 2 weeks. Maternal elevation of D-dimer level after FLP might be a warning indicator of VTE.
  • 眞山 学徳, 山口 正博, 細川 亜美, 中川 絹子, 馬詰 武, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    日本妊娠高血圧学会雑誌 25 93 - 93 (一社)日本妊娠高血圧学会 2018年11月
  • Superb Microvascular Imagingと、MRIとのSmart Fusionを用いて絨毛膜下血腫を同定できた1例
    山口 正博, 馬詰 武, 加藤 扶美, 細川 亜美, 眞山 学徳, 中川 絹子, 千葉 健太郎, 河口 哲, 森川 守, 渡利 英道
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 66回 0077 - 0077 東北連合産科婦人科学会・北日本産科婦人科学会 2018年09月
  • 当科で出生後にGoldenhar症候群(oculoauriculovertebral dysplasia)と診断された新生児における合併奇形と新生児予後
    桑島 一彦, 細川 亜美, 藤枝 聡子, 馬詰 武, 小島 崇史, 河口 哲, 石川 聡司, 長 和俊, 森川 守
    北海道産科婦人科学会会誌 62 1 71 - 77 北海道産科婦人科学会 2018年03月 
    【目的】Goldenhar症候群(GS)に代表的な顔面異常や脊椎形態異常以外の合併形態異常を伴った6例を経験したので、若干の文献的考察を加えて報告する。また、GSの予後を不良にする可能性のある合併形態異常について検討する。【症例】当科で2010年7月から2017年6月までに妊娠22週以降に出生した児2,518例のうち、GSだった6例において消化管閉鎖4例、心形態異常3例・肺低形成3例、腎低形成2例を認めた。生後6ヵ月で生存中の1例を除く5例では、生存1例、乳幼児死亡4例だった。死亡4例では心形態異常3例、消化管閉鎖3例、肺低形成2例、腎低形成1例を認めたが、生存1例では消化管閉鎖のみを認めた。【結語】他の合併形態異常(心形態異常、消化管閉鎖、肺低形成、腎低形成)を伴うGSは予後不良であった。(著者抄録)
  • 各種の治療で対応したvon Willebrand病合併妊娠の3例
    赤羽 慧一郎, 馬詰 武, 山田 崇弘, 金川 明功, 細川 亜美, 中川 絹子, 荒木 直人, 千葉 健太郎, 小島 崇史, 石川 聡司, 森川 守, 水上 尚典
    北海道産科婦人科学会会誌 62 1 179 - 180 北海道産科婦人科学会 2018年03月
  • 分娩前後での母体の心形態及び血行動態変化の検討 帝王切開と経腟分娩の比較
    細川 亜美, 馬詰 武, 山田 崇弘, 金川 明功, 中川 絹子, 荒木 直人, 千葉 健太郎, 小島 崇史, 石川 聡司, 森川 守, 水上 尚典
    北海道産科婦人科学会会誌 62 1 202 - 202 北海道産科婦人科学会 2018年03月
  • 妊娠経過に伴う尿中angiotensinogen排泄量の変動
    古田 伊都子, 馬詰 武, 森川 守, 水上 尚典
    日本産科婦人科学会雑誌 70 2 689 - 689 (公社)日本産科婦人科学会 2018年02月
  • 次回妊娠において妊娠高血圧症候群は再発しやすいか
    森川 守, 細川 亜美, 藤枝 聡子, 馬詰 武, 河口 哲, 小島 崇史, 石川 聡司, 長 和俊
    日本産科婦人科学会雑誌 70 2 808 - 808 (公社)日本産科婦人科学会 2018年02月
  • 糖尿病合併妊娠における妊娠初期のHbA1cと胎児異常の関連について
    細川 亜美, 藤井 タケル, 藤枝 聡子, 馬詰 武, 小島 崇史, 石川 聡司, 河口 哲, 森川 守
    日本産科婦人科学会雑誌 70 2 986 - 986 (公社)日本産科婦人科学会 2018年02月
  • 当科で出生後にGoldenhar症候群(oculoauriculovertebral dysplasia)と診断された新生児における合併奇形と新生児予後の関連
    桑島 一彦, 細川 亜美, 藤枝 聡子, 馬詰 武, 小島 崇史, 河口 哲, 石川 聡司, 長 和俊, 森川 守
    日本産科婦人科学会雑誌 70 2 1008 - 1008 (公社)日本産科婦人科学会 2018年02月
  • Takeshi Umazume, Takahiro Yamada, Satoshi Yamada, Satoshi Ishikawa, Itsuko Furuta, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Kazunori Okada, Mamoru Morikawa, Takashi Yamada, Kota Ono, Hiroyuki Tsutsui, Hisanori Minakami
    Open heart 5 2 e000850  2018年 [査読有り][通常論文]
     
    Objective: This longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum. Methods: Fifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum. Data on 255 echocardiography scans (five times per woman) and biomarkers were analysed. Results: Left ventricular end-diastolic dimension, left atrial (LA) volume index and left ventricular (LV) mass index increased with advancing gestation and reached the maximum immediately postpartum concomitant with the highest brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI) and creatine kinase MB levels. The inferior vena cava diameter was significantly reduced in the third trimester compared with that in the first trimester and the peak occurred immediately after childbirth. In 255 paired measurements, hs-TnI level was significantly positively correlated with LA volume index and LV mass index; BNP and NT-proBNP were significantly positively correlated with LA volume index and estimated glomerular filtration rate (eGFR) was significantly positively correlated with the average of early diastolic septal and lateral mitral annular velocity (e'). Conclusions: Maximal cardiac changes in morphology occurred postpartum within 1 week after childbirth, not during pregnancy. BNP/NT-proBNP, hs-TnI and eGFR reflected cardiac changes in pregnancy.
  • Takeshi Umazume, Satoshi Yamada, Takahiro Yamada, Satoshi Ishikawa, Itsuko Furuta, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Kazunori Okada, Mamoru Morikawa, Hiroyuki Tsutsui, Hisanori Minakami
    Open heart 5 2 e000829  2018年 [査読有り][通常論文]
     
    Objective: Women with hypertensive disorders of pregnancy (HDP) show elevated risk of heart failure despite decreased circulating plasma volume compared with those with normotensive control pregnancies (NCP). This study was performed to better characterise the heart in women with HDP and determine whether high-sensitivity troponin I (hs-TnI) around childbirth predicts reduced left ventricular (LV) relaxation at 1 month postpartum. Methods: Echocardiography was performed longitudinally during the first, second and third trimesters and immediately postpartum within 1 week and 1 month postpartum in 24 women with HDP, with simultaneous determination of blood variables in comparison with 51 women with NCP. Results: Compared with NCP, HDP showed greater antepartum left atrial (LA) volume, LV mass and inferior vena cava (IVC) diameter, higher peripartum brain natriuretic peptide/N-terminal pro-B-type natriuretic peptide and hs-TnI with the highest value immediately postpartum, and lower early diastolic mitral annular velocity (e') during pregnancy/postpartum. In analyses of data on HDP and NCP, hs-TnI at the third trimester as well as that immediately postpartum was negatively correlated with later e' at 1 month postpartum. The areas under the receiver operating characteristic curves were 0.82 and 0.81 for hs-TnI at the third trimester and immediately postpartum, respectively, in the prediction of reduced LV relaxation at 1 month postpartum. Conclusion: Reduced LV diastolic function and decreased splanchnic blood reservoir may contribute to the increased third trimester IVC diameter and LA volume in women with HDP. The rise in hs-TnI around childbirth was associated with poor LV relaxation ability at 1 month postpartum.
  • フローサイトメトリーを用いた胎児赤血球計量系の構築
    政氏 伸夫, 馬詰 武, 山田 崇弘, 長 和俊, 岡田 一範, 加賀 早苗, 森川 守
    臨床血液 58 12 2464 - 2464 (一社)日本血液学会-東京事務局 2017年12月
  • Sudden maternal hypoxemia during elective cesarean section in a woman with placenta previa.
    馬詰 武
    Clin Case Rep 5 10 1668 - 1671 2017年09月 [査読有り][通常論文]
  • 分娩前に診断し得た前置血管3症例の検討
    佐藤 帆奈美, 小島 崇史, 細川 亜美, 川端 公輔, 坂本 綾子, 中川 絹子, 藤枝 聡子, 馬詰 武, 千葉 健太郎, 河口 哲, 石川 聡司, 森川 守
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 65回 82 - 82 東北連合産科婦人科学会・北日本産科婦人科学会 2017年09月
  • 汎血球減少をきたした巨赤芽球性貧血合併妊娠の一例
    細川 亜美, 藤枝 聡子, 馬詰 武, 小島 崇史, 石川 聡司, 河口 哲, 森川 守
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 65回 122 - 122 東北連合産科婦人科学会・北日本産科婦人科学会 2017年09月
  • Itsuko Furuta, Takeshi Umazume, Takashi Kojima, Kentaro Chiba, Kinuko Nakagawa, Ami Hosokawa, Satoshi Ishikawa, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 7 1152 - 1158 2017年07月 [査読有り][通常論文]
     
    Aim This study was performed to determine the associations between serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) levels at mid-gestation with the risk of small-for-gestational-age (SGA) neonates born at gestational week (GW) 36 in healthy women. Methods PlGF and sFlt-1 concentrations were determined at GW 24-27 in 183 women with births at GW36, but without gestational diabetes mellitus and hypertension. Results Thirteen (7.1%) SGA neonates were born. Median (range) GW at blood sampling was similar between women with and without SGA (25 [24-25] and 24 [24-27], respectively, P = 0.671). Pre-pregnancy body mass index (BMI) and PlGF levels were significantly lower in women with than without SGA, while sFlt-1 levels and sFlt-1:PlGF ratio (sFlt-1/PlGF) did not differ significantly between the two groups. PlGF and sFlt-1/PlGF, but not BMI or sFlt-1, showed significant correlations with birthweight z-score; the correlation was positive for PlGF and negative for sFlt-1/PlGF. Women with PlGF level< 10th percentile and those with sFlt-1/PlGF level> 90th percentile showed significantly increased risk of SGA compared to those with respective counterpart characteristics; relative risk was 3.8 (95% confidence interval, 1.3-11.3; 21% [4/19] vs 5.5% [9/164]) for PlGF and 7.9 (95% confidence interval, 3.0-20.8, 33.3% [6/18] vs 4.2% [7/165]) for sFlt-1/PlGF. Conclusion Maternal PlGF and sFlt-1/PlGF determined during GW 24-27 were associated with the risk of SGA neonates born at GW >= 36, even in women with uncomplicated pregnancies.
  • Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Kinuko Nakagawa, Takashi Kojima, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    American Journal of Physiology - Renal Physiology 312 6 F1112 - F1119 2017年06月04日 [査読有り][通常論文]
     
    Changes in hemodynamics and blood pressure occur shortly before and after childbirth regardless of the mode of delivery. This study aimed to test the hypothesis that parturition induces a temporal increase in podocyturia monitored by podocyte-specific protein podocin mRNA expression levels (Pod-mRNA). A total of 105 urine specimens, consisting of 43 and 62 from 18 and 20 otherwise healthy women with vaginal delivery (VD) and elective cesarean delivery (ECS), respectively, were studied. Determination of urine protein and creatinine (Cr) concentrations and quantitative analyses of Pod-mRNA, nephrin mRNA (Nep-mRNA), synaptopodin mRNA (Syn-mRNA), and aquaporin 2 mRNA expression were performed using RT-PCR in pelleted urine samples. Levels of mRNA expression were corrected by urine Cr concentration. Podocyturia increased significantly, concomitant with a significantly decreased Nep:Pod-mRNA ratio (NPR) in the urine, collected immediately before or after childbirth regardless of the delivery mode compared with urine collected before commencement of labor or on postpartum day 3 or later. Podocyturia was significantly negatively correlated with NPR [correlation coefficient (r) =-0.614/-0.750 for VD/ECS women, respectively], as well as the Syn:Pod-mRNA ratio. Systolic blood pressure exceeded 140 mmHg during labor in 50% of VD women, and mean arterial pressure was significantly positively correlated with podocyturia during labor in VD women (r = 0.733). Thus parturition induces a transient increase in urine podocytes with reduced Nep- and Syn-mRNA expressions. Glomerular podocytes with reduced Nep- and Syn-mRNA levels were suggested to be likely to detach from the glomerular basement membrane around childbirth.
  • 細川 亜美, 馬詰 武, 山田 崇弘, 中川 絹子, 小島 崇史, 千葉 健太郎, 石川 聡司, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 53 2 613 - 613 (一社)日本周産期・新生児医学会 2017年06月
  • 小島 崇史, 山田 崇弘, 細川 亜美, 中川 絹子, 馬詰 武, 千葉 健太郎, 石川 聡司, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 53 2 661 - 661 (一社)日本周産期・新生児医学会 2017年06月
  • Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Ami Hosokawa, Takashi Kojima, Kentaro Chiba, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 6 1008 - 1013 2017年06月 [査読有り][通常論文]
     
    Aim: Urine podocin mRNA expression and urine podocin : nephrin mRNA expression ratio (PNR) increase with increasing proteinuria during pregnancy complicated with pre-eclampsia (PE). This suggests that urine podocytes with reduced nephrin mRNA expression are abundant in pathological podocyturia. The aim of this study was therefore to determine post-partum changes in podocyturia and PNR in relation to proteinuria after pre-eclampsia (PE). Methods: A total of 137 peripartum urine specimens, consisting of 72 and 65 from 24 and 30 women with PE and normotensive control pregnancies (NCP), respectively, were studied. Determination of urine protein and creatinine concentration and quantitative analysis of podocyte-specific podocin and nephrin mRNA expression were carried out using reverse transcription-polymerase chain reaction in pelleted urine samples. Podocyturia was monitored via urine podocin mRNA expression. Podocyturia and proteinuria were normalized by urine creatinine concentration. Results: Podocyturia and urine PNR decreased with decreasing proteinuria as well as with increasing time after delivery in the urine from PE women. In physiological proteinuria (i.e. protein : creatinine ratio [P/Cr] 0.005-0.1 mg/mg), however, both podocyturia and PNR were significantly greater in the urine from PE women compared with NPC women, although P/Cr was similar between the groups (median, 0.037 mg/mg for PE vs 0.029 mg/mg for NCP). Conclusions: Podocyturia decreases with decreasing proteinuria in PE women after childbirth. In PE women, however, pathological podocyturia consisting of podocytes with decreased nephrin mRNA expression persisted even after proteinuria decreased to a level similar to that in NCP women.
  • Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Kinuko Nakagawa, Takashi Kojima, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY 312 6 F1112 - F1119 2017年06月 [査読有り][通常論文]
     
    Changes in hemodynamics and blood pressure occur shortly before and after childbirth regardless of the mode of delivery. This study aimed to test the hypothesis that parturition induces a temporal increase in podocyturia monitored by podocyte-specific protein podocin mRNA expression levels (Pod-mRNA). A total of 105 urine specimens, consisting of 43 and 62 from 18 and 20 otherwise healthy women with vaginal delivery (VD) and elective cesarean delivery (ECS), respectively, were studied. Determination of urine protein and creatinine (Cr) concentrations and quantitative analyses of Pod-mRNA, nephrin mRNA (Nep-mRNA), synaptopodin mRNA (Syn-mRNA), and aquaporin 2 mRNA expression were performed using RT-PCR in pelleted urine samples. Levels of mRNA expression were corrected by urine Cr concentration. Podocyturia increased significantly, concomitant with a significantly decreased Nep:Pod-mRNA ratio (NPR) in the urine, collected immediately before or after childbirth regardless of the delivery mode compared with urine collected before commencement of labor or on postpartum day 3 or later. Podocyturia was significantly negatively correlated with NPR [correlation coefficient (r) = -0.614/-0.750 for VD/ECS women, respectively], as well as the Syn:Pod-mRNA ratio. Systolic blood pressure exceeded 140 mmHg during labor in 50% of VD women, and mean arterial pressure was significantly positively correlated with podocyturia during labor in VD women (r = 0.733). Thus parturition induces a transient increase in urine podocytes with reduced Nep- and Syn-mRNA expressions. Glomerular podocytes with reduced Nep- and Syn-mRNA levels were suggested to be likely to detach from the glomerular basement membrane around childbirth.
  • Ami Hosokawa, Takeshi Umazume, Takahiro Yamada, Hisanori Minakami
    BMJ case reports 2017 pii: bcr-2016-217964  2017年05月13日 [査読有り][通常論文]
     
    A 36-year-old nulliparous woman developed pre-eclampsia at gestational week (GW) 28-6/7 Cardiac status was checked regularly. Heart rate of 93 beats per minute (bpm) with left atrial diameter (LAD) of 35 mm, left ventricular hypertrophy and inferior vena cava diameter (IVCD) of 8 mm at GW 32-0/7 decreased to 48 bpm with an expanded IVCD to 25 mm, dilated left atrium (LAD to 39 mm), increased pulmonary arterial pressure, increased systemic vascular resistance (approximate 3000  dyn s/cm5) and biphasic intrarenal venous flow pattern 3.5 hours prior to childbirth at GW 32-3/7 Epigastralgia, tachycardia (160 bpm) and marked hypertension (201/111 mm Hg) occurring 2 hours after echocardiography necessitated caesarean section, with subsequent development of HELLP syndrome. Acute fluid shift from the splanchnic vasculature to central vasculature may have occurred causing HELLP syndrome as a result from vasospasm associated with sympathetic hyperactivity. The cause of bradycardia prior to tachycardia remains unclear.
  • Mamoru Morikawa, Kazutoshi Cho, Takashi Kojima, Kentaro Chiba, Satoshi Ishikawa, Takeshi Umazume, Kinuko Nakagawa, Takashi Yamada, Takahiro Yamada, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 5 866 - 872 2017年05月 [査読有り][通常論文]
     
    Aim: This study was performed to determine risk factors for central serous chorioretinopathy (CSC) in pregnant women. Methods: This retrospective observational study was performed in a cohort of all 1881 women giving birth at a single center. The hospital database was searched to abstract all women diagnosed with pre-eclampsia (PE) as well as those visiting the eye clinic during the current pregnancy. Medical chart review was performed in all women diagnosed with CSC and PE. Results: PE developed in 73 (3.9%) women, six (8.2%) of whom visited the eye clinic for problems occurring in the current pregnancy; 47 of 1808 (2.6%) women without PE visited the eye clinic (P = 0.015). Four women were identified as having developed CSC after onset of PE, and none of those without PE developed CSC (5.5% [4/73] vs 0.0% [0/1808], respectively, P < 0.0001). Stepwise regression analysis selected four risk factors for CSC: hematocrit value > 38.0% (odds ratio [OR], 22.9; 95% confidence interval [CI], 2.12-247), serum creatinine > 0.7 mg/dL (OR, 21.7; 95% CI, 1.12-422), time interval from diagnosis of PE until delivery > 14 days (OR, 20.0; 95% CI, 1.87-214), and urine protein : creatinine ratio (mg/mg) > 4.5 (OR, 15.7; 95% CI, 0.81-304). Hematocrit value-38.0% was finally identified as the only independent risk factor (OR, 22.9; 95% CI, 2.12-1716) for CSC in PE women. Conclusion: CSC was likely to occur in PE women, especially in those with hemoconcentration as a result of plasma leakage from the circulating blood due to increased vascular permeability.
  • Itsuko Furuta, Tianyue Zhai, Takeshi Umazume, Satoshi Ishikawa, Kinuko Nakagawa, Rina Akaishi, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 5 873 - 879 2017年05月 [査読有り][通常論文]
     
    Aim: Hyperfiltration is a cause of podocyturia and occurs physiologically in the kidney of pregnant women. Podocyturia is increased in preeclamptic pregnancies, but it is unclear whether there is also any increase in uncomplicated pregnancies. This study was performed to examine whether podocyturia and urine aquaporin 2 mRNA expression are increased in healthy pregnant women (PW) compared to healthy non-pregnant women (NPW). Methods: Eleven urines obtained from 11 NPW and longitudinal 76 urines from 40 PW with uncomplicated pregnancies (median number [range] of urine samples/person, 2 [1 - 3]) were studied. Determination of protein and creatinine concentrations and number of cells in urine other than blood cells, and quantitative analyses of the mRNA expression of aquaporin 2 (AQP2-mRNA), podocin (Pod-mRNA), and nephrin (Nep-mRNA) were performed using RT-PCR in pelleted urine samples. Podocyturia was monitored with urine Pod- and Nep-mRNA expression levels normalized relative to creatinine. Results: Urine cell density and urine AQP2-, Pod-, and Nep-mRNA expression normalized relative to creatinine were significantly higher in PW than NPW. The number of cells per milligram of creatinine was significantly positively correlated with expression of all three mRNAs with correlation coefficients (R-value) of 0.442, 0.481, and 0.561 for Pod-, Nep-, and AQP2-mRNA, respectively. AQP2-mRNA expression was strongly (R > 0.8) positively correlated with both Pod- and Nep-mRNA expression. Conclusion: Podocyturia monitored by Pod- and Nep-mRNA expression and urine cells expressing AQP2-mRNA were increased in uncomplicated pregnancies compared to healthy non-pregnant women. Urine cells expressing AQP2-mRNA increased with increasing podocyturia in healthy women.
  • 馬詰 武, 山田 崇弘, 古田 伊都子, 千葉 健太郎, 石川 聡司, 小山 貴弘, 赤石 理奈, 森川 守, 松野 一彦, 水上 尚典
    北海道産科婦人科学会会誌 61 1 53 - 54 北海道産科婦人科学会 2017年03月
  • 森川 守, 山田 俊, 馬詰 武, 木村 敬子, 川端 公輔, 中川 絹子, 千葉 健太郎, 小島 崇史, 荒木 直人, 小山 貴弘, 石川 聡司, 山田 崇弘, 長 和俊, 水上 尚典
    北海道産科婦人科学会会誌 61 1 54 - 55 北海道産科婦人科学会 2017年03月
  • 木村 敬子, 山田 崇弘, 川端 公輔, 中川 絹子, 馬詰 武, 荒木 直人, 千葉 健太郎, 小島 崇史, 石川 聡司, 小山 貴弘, 森川 守, 水上 尚典
    北海道産科婦人科学会会誌 61 1 59 - 60 北海道産科婦人科学会 2017年03月
  • 妊娠・分娩に伴う尿中podocyte排泄量の変化
    古田 伊都子, 馬詰 武, 中川 絹子, 山田 崇弘, 森川 守, 水上 尚典
    日本産科婦人科学会雑誌 69 2 655 - 655 (公社)日本産科婦人科学会 2017年02月
  • Yutaro Suzuki, Mie Yamamura, Keisuke Kikuchi, Rifumi Hattori, Takeshi Umazume, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 2 387 - 391 2017年02月 [査読有り][通常論文]
     
    Marked fluid retention occurs in Ballantyne syndrome, but few reports are available on changes in cardiac morphology in this syndrome. A woman with generalized edema, dyspnea, fetal hydrops (skin edema and ascites), thickened placenta, and elevated plasma B-type natriuretic peptide level (344 pg/mL) was admitted to our hospital at gestational week (GW) 20(+3). Blood pressure remained within the normal range. However, acute increases in left atrial volume index, pulmonary artery systolic pressure, and hyperdynamic left ventricular function (as evidenced by increased left ventricular ejection fraction to 74% with cardiac index of 5.1 L/min/m(2)) occurred preceding fetal death at GW 21(+4) in the presence of increased inferior vena cava diameter (23 mm) and relatively low systemic vascular resistance of 752 dyn.s/cm(5). These findings suggested life-threatening heart failure and required cesarean delivery at GW 21(+5) resulting in complete recovery. The placenta suggested cytomegalovirus infection.
  • Itsuko Furuta, Tianyue Zhai, Satoshi Ishikawa, Takeshi Umazume, Kinuko Nakagawa, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43 1 34 - 41 2017年01月 [査読有り][通常論文]
     
    AimPodocyte depletion in the kidney is associated with end-stage kidney disease (ESKD). Pre-eclampsia (PE) increases the risk of ESKD in later life. This study was performed to determine whether nephrinuria (soluble nephrin in the urine) is correlated with proteinuria and/or podocyturia (podocytes in the urine) in PE women. MethodsEighty-three urine samples, consisting of 45 and 38 samples from 27 normotensive and nine PE women, respectively, underwent simultaneous determination of nephrin, protein, and creatinine concentrations in the urine supernatant and quantitative analysis of podocyte-specific protein mRNA expression. This included podocin (Pod-mRNA) and nephrin (Nep-mRNA), using real-time polymerase chain reaction in the pelleted urine. Nephrinuria and proteinuria were corrected by creatinine concentration. Pod- and Nep-mRNA expression levels were corrected by GAPDH. ResultsNephrinuria, proteinuria, Pod-mRNA expression, and Nep-mRNA expression all increased with advancing gestation in PE women, while not in normotensive women. The nephrinuria was strongly correlated with proteinuria (R= 0.901, P < 0.001), Pod-mRNA expression level (R=0.824, P<0.001), and Nep-mRNA expression level (R = 0.724, P < 0.001) in urine samples from PE women, while the nephrinuria was significantly correlated with proteinuria alone (R = 0.419, P < 0.005) in urine samples from normotensive women. ConclusionNephrinuria reflected well the degrees of proteinuria and podocyturia in PE women. This suggested that increased nephrinuria/proteinuria was associated with podocyte loss in the kidneys of PE women.
  • Tianyue Zhai, Itsuko Furuta, Kinuko Nakagawa, Takashi Kojima, Takeshi Umazume, Satoshi Ishikawa, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    SCIENTIFIC REPORTS 6 37442  2016年11月 [査読有り][通常論文]
     
    This prospective observational study compare urine nephrin: creatinine ratio (NCR, ng/mg) with serum soluble fms-like tyrosine kinase-1: placental growth factor ratio (FPR, pg/pg) for preeclampsia (PE) prediction among unselected asymptomatic pregnant women in 2nd trimester. NCR and FPR were determined in 254 paired urine/blood samples collected simultaneously from 254 women at median gestational week (GW) 24 (range, 22-27) without hypertension or significant proteinuria in pregnancy (SPIP). Fifteen (5.9%) developed SPIP and hypertension at GW 34.0 (26.0-38.6) and 35.3 (27.6-38.6), respectively, and were diagnosed with PE at GW 35.7 (27.6-38.6). The 90th percentile level determined in 239 women normotensive throughout pregnancy gave NCR (139) sensitivity and positive predictive values (PPV) of 60% (9/15) and 27% (9/33), while those for serum FPR (4.85) were 40% (6/15) and 20% (6/30), respectively. Relative risks (95% CI) of later PE were 10.0 (3.82-26.4; 27% [9/33] vs. 2.7% [6/221]) and 4.98 (1.91-13.0; 20% [6/30] vs. 4.0% [9/224]) for NCR-positive and FPR-positive women, respectively. Cut-offs suggested by ROC gave NCR (86.6) sensitivity and PPV of 87% (13/15) and 17% (13/79), and FPR (8.8) values of 40% (6/15) and 40% (6/15), respectively. Thus, 2nd trimester NCR was superior to FPR for PE prediction.
  • 各種の治療で対応したvon Willebrand病合併妊娠の三例
    赤羽 慧一郎, 馬詰 武, 山田 崇弘, 金川 明功, 細川 亜美, 中川 絹子, 荒木 直人, 千葉 健太郎, 小島 崇史, 石川 聡司, 森川 守, 水上 尚典
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 64回 98 - 98 東北連合産科婦人科学会・北日本産科婦人科学会 2016年09月
  • 分娩前後での母体の心形態及び血行動態変化の検討 帝王切開と経腟分娩の比較
    細川 亜美, 馬詰 武, 山田 崇弘, 金川 明功, 中川 絹子, 荒木 直人, 千葉 健太郎, 小島 崇史, 石川 聡司, 森川 守, 水上 尚典
    北日本産科婦人科学会総会・学術講演会プログラム・抄録集 64回 126 - 126 東北連合産科婦人科学会・北日本産科婦人科学会 2016年09月
  • Takahiro Yamada, Mana Obata-Yasuoka, Hiromi Hamada, Yosuke Baba, Akihide Ohkuchi, Shun Yasuda, Kosuke Kawabata, Shiori Minakawa, Chihiro Hirai, Hideto Kusaka, Nao Murabayashi, Yusuke Inde, Michikazu Nagura, Takeshi Umazume, Atsuo Itakura, Makoto Maeda, Norimasa Sagawa, Yasumasa Ohno, Soromon Kataoka, Keiya Fujimori, Yoshiki Kudo, Tomoaki Ikeda, Akihito Nakai, Hisanori Minakami
    ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 95 9 1048 - 1054 2016年09月 [査読有り][通常論文]
     
    Introduction. Some pregnant women develop significant proteinuria in the absence of hypertension. However, clinical significance of isolated gestational proteinuria (IGP) is not well understood. This study aimed to determine the prevalence of IGP in singleton pregnancies and the proportion of women with IGP who subsequently developed preeclampsia (IGP-PE) among all PE cases. Material and methods. This was an observational study of 6819 women with singleton pregnancies at 12 centers, including 938 women with at least once determination of protein-to-creatinine ratio (P/Cr). Significant proteinuria in pregnancy (SPIP) was defined as P/Cr (mg/mg) level >0.27. IGP was defined as SPIP in the absence of hypertension. Gestational hypertension (GH) preceding preeclampsia (GH-PE) was defined as preeclampsia (PE) in which GH preceded SPIP. Simultaneous PE (S-PE) was defined as PE in which both SPIP and hypertension occurred simultaneously. Results. IGP and PE were diagnosed in 130 (1.9%) and 158 (2.3%) of 6819 women, respectively. Of 130 women with IGP, 32 (25%) progressed to PE and accounted for 20% of all women with PE. Hence, women with IGP had a relative risk of 13.1 (95% CI; 9.2-18.5) for developing PE compared with those without IGP [25% (32/130) vs. 1.9% (126/6689)]. At diagnosis of SPIP, P/Cr levels already exceeded 1.0 more often in women with S-PE than in those with IGP-PE [67% (33/49) vs. 44% (14/32), respectively, p = 0.031]. Conclusions. IGP is a risk factor for PE, and IGP-PE accounts for a considerable proportion (20%) of all PE.
  • T. Umazume, T. Yamada, M. Morikawa, S. Ishikawa, T. Kojima, K. Cho, N. Masauzi, H. Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 42 6 632 - 639 2016年06月 [査読有り][通常論文]
     
    Aim: Women with pre-eclampsia (PE), placenta previa (PP), placental abruption (PA), and placental mesenchymal dysplasia (PMD) have been described as having placental permeability dysfunction. This study was performed to determine whether occult fetomaternal hemorrhage (FMH) is common in women with such complications and in women with non-reassuring fetal status. Methods: Forty-one antenatal and 39 postnatal blood samples were obtained from 46 women, including 11 with placental permeability dysfunction (5, 3, 2, and 1 with PE, PP, PA, and PMD, respectively) and 35 controls without such complications. To estimate the amount of fetal red blood cells, flow cytometry was performed using the fetal cell count system with two antibodies against fetal hemoglobin and carbonic anhydrase and the beta-gamma system with two monoclonal antibodies against hemoglobin beta-chain and hemoglobin gamma-chain. A diagnosis of FMH was made when the fraction size of the isolated cell population on scatter plots expressing fetal hemoglobin alone or hemoglobin gamma-chain alone accounted for >= 0.02% of the total cell population on scatter plots. Results: FMH was identified in five women, including one each with PE, PA, PP, PMD, and no complications. Thus, the prevalence rate of FMH was significantly higher in women with complications than in controls (36% [4/11] vs 2.9% [1/35], respectively, P = 0.009). The FMH occurrence rate did not differ between women with and without non-reassuring fetal status (7.7% [1/13] vs 12% [4/33], respectively, P = 1.000). Conclusion: The risk of fetal red blood cells trafficking into the maternal circulation may be increased in women complicated with PE, PA, PP, and PMD.
  • 馬詰 武, 山田 崇弘, 中川 絹子, 坂本 綾子, 川端 公輔, 齊藤 良玄, 小島 崇史, 石川 聡司, 小山 貴弘, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 52 2 498 - 498 (一社)日本周産期・新生児医学会 2016年06月
  • 森川 守, 平山 恵美, 馬詰 武, 中川 絹子, 小島 崇史, 千葉 健太郎, 石川 聡司, 山田 崇弘, 長 和俊, 奥山 和彦, 水上 尚典
    日本周産期・新生児医学会雑誌 52 2 499 - 499 (一社)日本周産期・新生児医学会 2016年06月
  • 中川 絹子, 馬詰 武, 山田 崇弘, 川端 公輔, 坂本 綾子, 齊藤 良玄, 小島 崇史, 石川 聡司, 小山 貴弘, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 52 2 756 - 756 (一社)日本周産期・新生児医学会 2016年06月
  • 齊藤 良玄, 森川 守, 川端 公輔, 坂本 綾子, 中川 絹子, 馬詰 武, 小島 崇史, 千葉 健太郎, 小山 貴弘, 石川 聡司, 山田 崇弘, 水上 尚典
    日本周産期・新生児医学会雑誌 52 2 780 - 780 (一社)日本周産期・新生児医学会 2016年06月
  • 妊娠初期の血小板凝集塊形成についての検討
    馬詰 武, 松野 一彦, 山田 崇弘, 古田 伊都子, 千葉 健太郎, 石川 聡司, 小山 貴弘, 赤石 理奈, 森川 守, 水上 尚典
    日本血栓止血学会誌 27 2 237 - 237 (一社)日本血栓止血学会 2016年05月
  • 単胎妊娠と双胎妊娠の血小板凝集塊形成の比較
    馬詰 武, 松野 一彦, 山田 崇弘, 古田 伊都子, 千葉 健太郎, 石川 聡司, 小山 貴弘, 赤石 理奈, 森川 守, 水上 尚典
    日本血栓止血学会誌 27 2 238 - 238 (一社)日本血栓止血学会 2016年05月
  • Ishikawa S, Morikawa M, Umazume T, Yamada T, Kanno H, Takakuwa E, Minakami H
    Clinical case reports 4 5 463 - 465 2016年05月 [査読有り][通常論文]
  • 妊娠28週で子宮内胎児死亡となった胎児上顎体の一例
    川端 公輔, 中川 絹子, 馬詰 武, 千葉 健太郎, 小島 崇史, 小山 貴弘, 石川 聡司, 山田 崇弘, 森川 守, 水上 尚典
    超音波医学 43 Suppl. S847 - S847 (公社)日本超音波医学会 2016年04月
  • Takeshi Umazume, Takahiro Yamada, Mamoru Morikawa, Satoshi Ishikawa, Itsuko Furuta, Takahiro Koyama, Kazuhiko Matsuno, Hisanori Minakami
    THROMBOSIS RESEARCH 138 43 - 48 2016年02月 [査読有り][通常論文]
     
    Background: Gestational thrombocytopenia is more likely to occur in twin than singleton pregnancies. However, it is unclear whether platelets are more reactive in twin than singleton pregnancies. Methods: Changes in spontaneous platelet aggregation and concomitant fall in platelet count were examined over 90 min after blood sampling in 171 and 52 citrated whole blood (CWB) samples from 59 and 17 women with singleton and twin pregnancies, respectively. Soluble P-selectin (sP-selectin) levels in the plasma were also determined. Results: CWB 60 min after blood sampling during 2nd trimester exhibited significantly larger numbers of platelet aggregates (1297 +/- 1600 vs. 497 +/- 432/mu l, P = 0.040) concomitant with significantly greater net decrease in platelet count (152 +/- 55 vs. 115 +/- 45 x 10(9)/mu l, P = 0.036) in twin than singleton pregnancies, respectively. This was followed by significantly lower 3rd trimester platelet count (181 +/- 43 vs. 229 +/- 62 x 10(9)/l, P = 0.009) with significantly greater mean platelet volume (8.0 +/- 1.2 vs. 7.1 +/- 1.1 fl, P = 0.021) in twin than singleton pregnancies, respectively. The 3rd trimester sP-selectin per platelet was significantly higher in twin than singleton pregnancies. Conclusions: Platelets were more reactive in the 2nd trimester of twin than singleton pregnancies. This enhanced platelet reactivity may explain the decreased platelet count in the 3rd trimester of twin pregnancy. (C) 2016 Elsevier Ltd. All rights reserved.
  • Takeshi Umazume, Mamoru Morikawa, Takahiro Yamada, Hisanori Minakami
    BMJ Case Reports 2016 pii: bcr2016216012.  2016年 [査読有り][通常論文]
     
    We report a pregnant woman who was monitored by echocardiography and determination of blood variables, including components of the renin-angiotensin- aldosterone system (RAAS), cardiac biomarkers and soluble fms-like tyrosine kinase-1 (sFlt-1), during and after the development of Ballantyne syndrome. Generalised maternal oedema with dyspnoea following fetal and placental hydrops necessitated a caesarean section at 33 weeks of gestation. Changes in blood variables and simultaneous echocardiography changes indicated acutely enhanced RAAS and hyperdynamic left ventricular function in response to excessive volume overload (as evidenced by brain-type natriuretic peptide level of 523 pg/mL) in the absence of increased systemic vascular resistance. Elevated sFlt-1 (15 600 pg/mL) and human chorionic gonadotrophin (404 000 IU/L) levels were also noted. The increased plasma aldosterone concentration (2070 pg/mL) may have been responsible for the increase in circulating plasma volume, and the increased sFlt-1 level was responsible for generalised maternal oedema. It remains unclear which factor(s) triggered RAAS activation.
  • Tianyue Zhai, Itsuko Furuta, Rina Akaishi, Kosuke Kawabata, Kentaro Chiba, Takeshi Umazume, Satoshi Ishikawa, Takahiro Yamada, Mamoru Morikawa, Hisanori Minakami
    BMJ OPEN 6 8 e011229 - e011229 2016年 [査読有り][通常論文]
     
    Objectives: To investigate the possibility of nephrinuria as a screening tool for the risk of pre-eclampsia (PE). Design: Prospective observational study. Setting: A single university hospital. Changes in urinary nephrin: creatinine ratio (NCR, ng/mg) and protein: creatinine ratio (PCR, mg/mg) in pregnancy were determined. Significant proteinuria in pregnancy (SPIP) was defined as PCR> 0.27. PE was diagnosed in women with both SPIP and hypertension. Participants: 89 pregnant women in whom neither hypertension nor SPIP was present at enrolment, providing 31, 125 and 93 random urine samples during first, second and third trimesters, respectively. Results: PE developed in 14 of the 89 women. NCR increased with increasing PCR in 14 women with PE (correlation coefficient, 0.862; p<0.0001). In contrast, NCR did not change significantly despite significant increases in PCR in 75 women with normotensive pregnancies defined as neither SPIP nor hypertension, indicating that there was little increase in nephrinuria over the physiological range of proteinuria in pregnancy. Relative risk of later development of PE among asymptomatic second and third trimester women with NCR (ng/mg) > 122 (95th centile value for 75 women with normotensive pregnancies) was 5.93 (95% CI 2.59 to 13.6; 60% (6/10) vs 10% (8/79)) and 13.5 (95% CI 3.31 to 55.0; 75% (6/8) vs 5.5% (2/36)), respectively, compared with women with NCR <= 122 at that time. Conclusions: Nephrinuria was unlikely to increase in normal pregnancy. A certain NCR cut-off may efficiently differentiate women at higher risk of PE.
  • 【周産期医学必修知識第8版】 産科編 B群溶血性レンサ球菌感染症
    馬詰 武, 山田 崇弘, 水上 尚典
    周産期医学 46 155 - 157 2016年 [査読無し][招待有り]
  • Takeshi Umazume, Mamoru Morikawa, Takahiro Yamada, Kazutoshi Cho, Nobuo Masauzi, Hisanori Minakami
    Clinical case reports 3 11 916 - 9 2015年11月 [査読有り][通常論文]
     
    It is not clear that how long the affected fetuses can tolerate fetomaternal hemorrhage (FMH). Incidental serial measurements of the fetal peak systolic velocity of the middle cerebral artery and the retrospective analysis of stocked blood available incidentally indicated that our patient had suffered from FMH for at least 2 weeks prior to delivery.
  • Takeshi Umazume, Takahiro Yamada, Satoshi Ishikawa, Takashi Yamada, Takahiro Koyama, Itsuko Furuta, Mamoru Morikawa, Satoshi Yamada, Hisanori Minakami
    ESC heart failure 2 3 208 - 215 2015年09月 [査読有り][通常論文]
     
    AIMS: Echocardiography is necessary for the diagnosis of peripartum cardiomyopathy (PPCM). Multifetal pregnancies (MFP) and hypertensive disorders (HD) are prominent risk factors for PPCM. To determine which blood variables exhibit greater change in a late stage of pregnancy in women with MFP and/or HD compared with women with normotensive singleton pregnancies. METHODS AND RESULTS: Serum levels of six variables-high-sensitive troponin I (hs-TnI), N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP), myoglobin, creatine kinase-myocardial band, ferritin, and prolactin-were compared between 29 women with MFP (n = 13) and/or HD (n = 18) and 100 women with normotensive singleton pregnancies (control group). None of 129 women developed PPCM. All variables increased significantly peripartum in both groups. In 29 women with MFP and/or HD, the elevated hs-TnI and NT-proBNP levels (median) were significantly higher compared with the control group (5.4 vs. 3.7 pg/mL for hs-TnI with P = 0.002, 185 vs. 68 pg/mL for NT-proBNP with P = 0.007), and the prevalence rate of more than 90th percentile value specific for the 129 women was significantly more frequent for hs-TnI (>12.2 pg/mL; 31% [9/29] vs. 4.0% [4/100], P < 0.001) and tended to be more frequent for NT-proBNP (>342 pg/mL; 21% [6/29] vs. 7.0%, P = 0.072). CONCLUSIONS: Both hs-TnI and NT-proBNP were likely to increase markedly in women with MFP and/or HD. The combination of hs-TnI and NT-proBNP may contribute to better selection of candidates for echocardiography.
  • Takeshi Umazume, Takahiro Yamada, Mamoru Morikawa, Satoshi Ishikawa, Itsuko Furuta, Takahiro Koyama, Kazuhiko Matsuno, Hisanori Minakami
    CLINICA CHIMICA ACTA 448 60 - 64 2015年08月 [査読有り][通常論文]
     
    Background: It was recently suggested that platelet reactivity is reduced in early pregnancy. This study was performed to determine whether the citrated whole blood from 33 pregnant women in their first trimester showed spontaneous platelet aggregation and whether it differed in extent from that of 11 non-pregnant women. Methods: The platelet count and number of platelet aggregates (PA) were serially determined in the same citrated whole blood specimens at 15, 30, 45, 60, 75, and 90 min after blood sampling using a hematology analyzer. Results: The number of PA increased significantly at 30 min and thereafter in both groups, but was consistently lower for pregnant than non-pregnant women over the 90-min observation period. The platelet count decreased significantly in a time-dependent manner in both groups, but was significantly lower at 30 and 90 min for nonpregnant than pregnant women. The number of PA showed a significant positive correlation with net decrease in platelet count for both pregnant and non-pregnant women. PA counts were also significantly positively correlated with the mean platelet volume. Conclusion: Platelet reactivity monitored by the increase in number of PA and the fall in platelet count was reduced in early pregnancy compared with non-pregnant healthy controls. (C) 2015 Elsevier B.V. All rights reserved.
  • 森川 守, 山田 竜太郎, 馬詰 武, 小島 崇史, 小山 貴弘, 石川 聡司, 赤石 理奈, 西田 竜太郎, 荒木 直人, 山田 崇弘, 水上 尚典
    糖尿病と妊娠 15 1 82 - 82 (一社)日本糖尿病・妊娠学会 2015年08月
  • 馬詰 武, 山田 崇弘, 山田 竜太郎, 小島 崇史, 赤石 理奈, 石川 聡司, 小山 貴弘, 西田 竜太郎, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 51 2 676 - 676 (一社)日本周産期・新生児医学会 2015年06月
  • 馬詰 武, 山田 崇弘, 山田 竜太郎, 小島 崇史, 赤石 理奈, 石川 聡司, 小山 貴弘, 西田 竜太郎, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 51 2 716 - 716 (一社)日本周産期・新生児医学会 2015年06月
  • Takeshi Umazume, Mamoru Morikawa, Takahiro Yamada, Rina Akaishi, Takahiro Koyama, Hisanori Minakami
    Clinical case reports 3 4 213 - 6 2015年04月 [査読有り][通常論文]
     
    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.
  • R. Akaishi, T. Yamada, S. Kawaguchi, T. Kojima, T. Koyama, T. Umazume, M. Morikawa, K. Cho, H. Minakami
    ULTRASOUND IN OBSTETRICS & GYNECOLOGY 45 1 113 - 114 2015年01月 [査読有り][通常論文]
  • 陣痛発来入院時のアンチトロンビン(AT)活性値定期測定で偶然発見されたAT欠損症
    森川 守, 山田 竜太郎, 馬詰 武, 小島 崇史, 赤石 理奈, 小山 貴弘, 石川 聡司, 荒木 直人, 山田 崇弘, 長 和俊, 水上 尚典
    日本産婦人科・新生児血液学会誌 25 24 - 25 2015年 [査読有り][通常論文]
  • Takeshi Umazume, Takahiro Yamada, Satoshi Yamada, Hisanori Minakami
    BMJ Case Reports 2014 pii: bcr2014208186.  2014年11月20日 [査読有り][通常論文]
     
    A 27-year-old nulliparous Japanese woman with twin pregnancy developed preeclampsia at gestational week (GW) 26. Cardiac function was checked regularly as women carrying twins with preeclampsia are expected to have increased risk of peripartum cardiomyopathy (PPCM). Although conventional parameters including blood pressure, proteinuria, platelet count and liver function did not indicate early delivery, gradual worsening of left ventricular ejection fraction (LVEF) to 44% and plasma brain-type natriuretic peptide level of 254 pg/mL suggested impending PPCM and a need for early delivery at GW 32. A nadir LVEF value of 35% on postpartum day (PPD) 3 followed by a value of 49% on PPD 32 was seen in this patient with PPCM. This case highlights the risk of PPCM among women with preeclampsia carrying twins and the role of pregnancy termination in the clinical course of PPCM.
  • 妊娠糖尿病の血糖管理と血糖自己測定法(SMBG) 血糖自己測定法(SMBG)は全ての妊娠糖尿病(GDM)妊婦に必要か?
    森川 守, 山田 竜太郎, 馬詰 武, 小島 崇史, 小山 貴弘, 石川 聡司, 赤石 理奈, 西田 竜太郎, 荒木 直人, 山田 崇弘, 水上 尚典
    糖尿病と妊娠 14 2 S - 74 (一社)日本糖尿病・妊娠学会 2014年10月
  • 西田 竜太郎, 嶋田 知紗, 馬詰 武, 小島 崇史, 小山 貴弘, 赤石 理奈, 山田 崇弘, 森川 守, 山田 俊, 長 和俊, 水上 尚典
    日本周産期・新生児医学会雑誌 50 2 717 - 717 (一社)日本周産期・新生児医学会 2014年06月
  • 馬詰 武, 山田 崇弘, 嶋田 知紗, 小島 崇史, 小山 貴弘, 赤石 理奈, 西田 竜太郎, 森川 守, 水上 尚典
    日本周産期・新生児医学会雑誌 50 2 858 - 858 (一社)日本周産期・新生児医学会 2014年06月
  • 森川 守, 馬詰 武, 小島 崇史, 小山 貴弘, 赤石 理奈, 西田 竜太郎, 荒木 直人, 山田 崇弘, 長 和俊, 水上 尚典
    日本産婦人科・新生児血液学会誌 24 1 S - 82 日本産婦人科・新生児血液学会 2014年05月
  • Takeshi Umazume, Takahiro Yamada, Rina Akaishi, Naoto Araki, Ryutaro Nishida, Mamoru Morikawa, Hisanori Minakami
    THROMBOSIS RESEARCH 133 2 158 - 161 2014年02月 [査読有り][通常論文]
     
    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 still birth was extremely high among women with ET. More intensified monitoring of fetal wellbeing may be required to improve outcome of pregnancy complicated with ET. (C) 2013 Elsevier Ltd. All rights reserved.
  • 馬詰 武
    日本臨床細胞学会雑誌 51 2 132 - 136 2012年 [査読有り][通常論文]
  • Shinichiro Minobe, Yukiharu Todo, Yoshihiro Suzuki, Yukiko Aoyagi, Takeshi Umazume, Kazuhira Okamoto, Hidenori Kato
    Journal of Obstetrics and Gynaecology Research 37 6 645 - 649 2011年06月 [査読有り][通常論文]
     
    The prognosis of uterine leiomyosarcoma (LMS) is notoriously poor and a standard chemotherapy for patients with uterine LMS has not yet been established. Here, we describe two patients with recurrent LMS of the uterus who were treated with mesna, doxorubicin, ifosfamide and dacarbazine chemotherapy one achieved complete and the other partial remission. © 2011 The Authors.
  • Takeshi Umazume, Soromon Kataoka, Kyouko Kamamuta, Fumie Tanuma, Akihiko Sumie, Toru Shirogane, Takayuki Kudou, Hitoshi Ikeda
    DIAGNOSTIC PATHOLOGY 6 38  2011年04月 [査読有り][通常論文]
     
    We report a 32-year-old woman (1-gravid, 1-para) with a vesicular lesion in her uterus that was pointed out on ultrasound at 8 weeks' gestation. Amniocentesis at 15 weeks' gestation showed a normal female karyotype, 46XX. As the pregnancy advanced, the mole-like lesion became relatively reduced. Throughout gestation, the maternal human chorionic gonadotropin level was normal, but the serum alpha fetoprotein level rose as her pregnancy progressed. Her fetus did not exhibit any remarkable anomalies. The patient visited our hospital complaining of a diminished feeling of fetal movements at 36 weeks 5 days' gestation, and intrauterine fetal death (IUFD) was confirmed. She delivered a 2336-g female without any definite anomalies. A pathological examination led to a diagnosis of placental mesenchymal dysplasia, and androgenetic/biparental mosaicism in the placenta was identified using p57(kip2) immunohistochemical staining. And it also revealed that the rupture of the cirsoid chorionic vessels had led to IUFD.

書籍

講演・口頭発表等

  • 妊婦の心形態・機能の変化と周産期心筋症スクリーニングの新しい可能性  [通常講演]
    馬詰 武
    第28回日本心エコー図学会学術集会 2017年04月 シンポジウム・ワークショップパネル(指名)
  • Difference in changes in echocardiographic parameters and biomarkers in women undergoing elective caesarean vs vaginal delivery  [通常講演]
    馬詰 武
    American Heart Association Scientific Sessions 2016 2016年11月 ポスター発表
  • 周産期心筋症早期発見のためのバイオマーカーの活用  [通常講演]
    馬詰 武
    第20回日本心不全学会学術集会 2016年10月 シンポジウム・ワークショップパネル(指名)
  • 妊娠中の心形態・機能の変化  [招待講演]
    馬詰 武
    第40回日本産科婦人科栄養・代謝研究会 2016年09月 公開講演,セミナー,チュートリアル,講習,講義等
  • Alterations in Cardiac Morphology and Function in Pregnancy and Their Association with Cardiovascular Biomarkers.  [通常講演]
    馬詰 武
    European Society of Cardiology Congress 2016 2016年08月 ポスター発表
  • 妊娠はダイナミックに血小板凝集能を変化させる  [招待講演]
    馬詰 武
    Abott Fair 2016 札幌 2016年07月 公開講演,セミナー,チュートリアル,講習,講義等

その他活動・業績

受賞

  • 2021年02月 内閣府 第三回日本オープンイノベーション大賞日本学術会議会長賞
  • 2016年10月 日本超音波医学会北海道地方会 妊娠高血圧腎症の急性増悪時に腎静脈血流速波形の変化を認めた1例
     
    受賞者: 馬詰 武
  • 2016年09月 北日本産婦人科学会 北海道産科婦人科学会学術奨励賞
     双胎妊娠における血小板凝集能:単体妊娠との比較 
    受賞者: 馬詰 武
  • 2016年03月 北海道心血管エコー研究会 優秀演題賞
     妊娠中から分娩後の心形態と機能の変化:周産期心筋症の早期診断を目指して 
    受賞者: 馬詰 武

教育活動情報

主要な担当授業

  • 基本医学総論
    開講年度 : 2021年
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 妊娠の成立 妊娠・分娩の生理と病理
  • 基本医学研究
    開講年度 : 2021年
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 女性特有の内分泌 妊娠の成立 妊娠・分娩の生理と病理 婦人科疾患 婦人科悪性腫瘍 Reproductive Endocrinology Establishment of pregnancy Physiology and pathology of pregnancy and labor Gynecologic diseases Gynecologic cancer
  • 医学総論
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 妊娠の成立 妊娠・分娩の生理と病理
  • 基盤医学研究
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 婦人科学 婦人科腫瘍、婦人科病理、卵巣内分泌、臨床遺伝 産科学 周産期、臨床遺伝
  • 臨床医学研究
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 婦人科学 婦人科腫瘍、婦人科病理、卵巣内分泌、臨床遺伝 産科学 周産期、臨床遺伝

大学運営

委員歴

  • 2021年06月 - 現在   日本産科婦人科学会   産科診療ガイドライン産科編2023作成委員
  • 2018年04月 - 現在   北海道産科婦人科学会   評議員
  • 2017年08月 - 現在   北海道周産期談話会   世話人・事務局
  • 2017年07月 - 2020年10月   北海道胎児心エコー研究会   副代表幹事
  • 2019年06月 - 2020年05月   日本産科婦人科学会   幹事


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