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  1. Article ; Online: Time trend analysis of perinatal mortality, stillbirth, and early neonatal mortality of multiple pregnancies for each gestational week from the year 2000 to 2019: A population-based study in Japan.

    Hayata, Eijiro / Nakata, Masahiko / Morita, Mineto

    PloS one

    2022  Volume 17, Issue 7, Page(s) e0272075

    Abstract: Multiple pregnancies pose a high risk of morbidity and mortality in both mothers and infants; thus, obtaining reliable information based on a large population is essential to improve management. We used the maternal and child health statistics, which are ...

    Abstract Multiple pregnancies pose a high risk of morbidity and mortality in both mothers and infants; thus, obtaining reliable information based on a large population is essential to improve management. We used the maternal and child health statistics, which are published annually, from the database of the Ministry of Health, Labor, and Welfare. The data obtained were aggregated in 5-year intervals, and we used them to analyze the proportion of the number of births for each week of pregnancy to the total of each singleton and multiple pregnancy. For perinatal health indicators (perinatal mortality, stillbirth, and neonatal mortality), the obtained data were calculated and plotted on graphs for each week of pregnancy. Moreover, these indicators were calculated by dividing them into first twin and second twin fetuses. Stillbirth weights were aggregated in several groups, and a histogram was displayed. Between 2000 and 2019, there were 21,068,275 live births, 67,666 stillbirths, and 16,443 early neonatal deaths, excluding 7,148 (7,104 singletons, 44 multiple births) cases, in which the exact gestational weeks at birth were unknown. More than 95% of multiple pregnancies were twin births. Perinatal mortality, stillbirth, and early neonatal mortality rates in multiple pregnancies were the lowest at approximately 37 weeks of gestation and lower than those of single pregnancies at approximately 36 weeks of gestation. Perinatal mortality and stillbirth rates were higher during the delivery of the second twins than the first-born twins, but the early neonatal mortality rate remained approximately the same during the delivery of both twins. As the data in the government database are accumulated and published continuously, indicators can be calculated in the future using the method presented in this study. Further, our findings may be useful for policymaking related to managing multiple pregnancies.
    MeSH term(s) Child ; Female ; Gestational Age ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Japan/epidemiology ; Perinatal Death ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin ; Stillbirth/epidemiology
    Language English
    Publishing date 2022-07-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0272075
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Trends in Syphilis in Pregnant Women in Japan in 2016 and 2022.

    Hayata, Eijiro / Suzuki, Shunji / Hoshi, Shin-Ichi / Sekizawa, Akihiko / Sagara, Yoko / Ishiwata, Isamu / Kitamura, Tadaichi

    Cureus

    2024  Volume 16, Issue 3, Page(s) e56292

    Abstract: Since 2012, the rate of syphilis infection has increased dramatically in high-income countries including Japan. In this study, we examined the rate of syphilis infection among pregnant women and perinatal outcomes in the syphilis-infected pregnancy in ... ...

    Abstract Since 2012, the rate of syphilis infection has increased dramatically in high-income countries including Japan. In this study, we examined the rate of syphilis infection among pregnant women and perinatal outcomes in the syphilis-infected pregnancy in 2022 in Japan, and compared the results with those in 2016. We requested 2,005 obstetric institutes to provide information on syphilis infection in pregnant women who delivered in 2022. A total of 1,346 obstetrical facilities responded with valid information. We compared the results with those in our previous study. The prevalence of syphilis-infected pregnant women was 1/1,215. The incidence of preterm delivery, intrauterine fetal demise and congenital syphilis in surviving neonates in the syphilis-infected pregnancy were 9%, 2% and 7%, respectively. The prevalence of syphilis-infected pregnant women has increased significantly, while the incidence of congenital syphilis seems to have decreased clinically.
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.56292
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Conservative management of uterine artery pseudoaneurysm occurring during treatment of gestational trophoblastic disease: A case report.

    Hayata, Eijiro / Komiyama, Shinichi / Nagashima, Masaru / Taniguchi, Tomoko / Morita, Mineto

    The journal of obstetrics and gynaecology research

    2020  Volume 46, Issue 10, Page(s) 2169–2173

    Abstract: Uterine artery pseudoaneurysm (UAP) is a rare disease that causes genital bleeding during the postpartum period after cesarean section. Uterine artery embolization (UAE) is an effective procedure for UAP. UAP was unexpectedly encountered in a patient ... ...

    Abstract Uterine artery pseudoaneurysm (UAP) is a rare disease that causes genital bleeding during the postpartum period after cesarean section. Uterine artery embolization (UAE) is an effective procedure for UAP. UAP was unexpectedly encountered in a patient with gestational trophoblastic disease; however, this patient was conservatively managed without UAE. UAP can occur during treatment for gestational trophoblastic disease. Since asymptomatic UAP may spontaneously disappear, in the selection of conservative treatment, it is important to carefully monitor patients using transvaginal ultrasonography focusing on the size of the UAP and the speed of internal blood flow.
    MeSH term(s) Aneurysm, False/diagnostic imaging ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; Cesarean Section ; Conservative Treatment ; Female ; Gestational Trophoblastic Disease/therapy ; Humans ; Pregnancy ; Uterine Artery/diagnostic imaging
    Language English
    Publishing date 2020-08-06
    Publishing country Australia
    Document type Case Reports
    ZDB-ID 1327307-3
    ISSN 1447-0756 ; 1341-8076
    ISSN (online) 1447-0756
    ISSN 1341-8076
    DOI 10.1111/jog.14409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The geographical maldistribution of obstetricians and gynecologists in Japan.

    Matsumoto, Kunichika / Seto, Kanako / Hayata, Eijiro / Fujita, Shigeru / Hatakeyama, Yosuke / Onishi, Ryo / Hasegawa, Tomonori

    PloS one

    2021  Volume 16, Issue 1, Page(s) e0245385

    Abstract: Background: In Japan, there is a large geographical maldistribution of obstetricians/gynecologists, with a high proportion of females. This study seeks to clarify how the increase in the proportion of female physicians affects the geographical ... ...

    Abstract Background: In Japan, there is a large geographical maldistribution of obstetricians/gynecologists, with a high proportion of females. This study seeks to clarify how the increase in the proportion of female physicians affects the geographical maldistribution of obstetrics/gynecologists.
    Methods: Governmental data of the Survey of Physicians, Dentists and Pharmacists between 1996 and 2016 were used. The Gini coefficient was used to measure the geographical maldistribution. We divided obstetricians/gynecologists into four groups based on age and gender: males under 40 years, females under 40 years, males aged 40 years and above, and females aged 40 years and above, and the time trend of the maldistribution and contribution of each group was evaluated.
    Results: The maldistribution of obstetricians/gynecologists was found to be worse during the study period, with the Gini coefficient exceeding 0.400 in 2016. The contribution ratios of female physicians to the deterioration of geographical maldistribution have been increasing for those under 40 years and those aged 40 years and above. However, there was a continuous decrease in the Gini coefficient of the two groups.
    Conclusions: The increase in the contribution ratio of the female physician groups to the Gini coefficient in obstetrics/gynecology may be due to the increased weight of these groups. The Gini coefficients of the female groups were also found to be on a decline. Although this may be because the working environment for female physicians improved or more female physicians established their practice in previously underserved areas, such a notion needs to be investigated in a follow-up study.
    MeSH term(s) Adult ; Female ; Gynecology ; Humans ; Japan ; Male ; Obstetrics ; Physicians/supply & distribution ; Physicians, Women/supply & distribution
    Language English
    Publishing date 2021-01-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0245385
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Biochemical effects of intraoperative cell salvage and autotransfusion during cesarean section: A prospective pilot study.

    Hayata, Eijiro / Nakata, Masahiko / Takano, Mayumi / Nagasaki, Sumito / Oji, Ayako / Sakuma, Junya / Morita, Mineto

    The journal of obstetrics and gynaecology research

    2021  Volume 47, Issue 5, Page(s) 1743–1750

    Abstract: Aim: Intraoperative cell salvage and autotransfusion (ICSA) is a useful technique for women undergoing cesarean sections who are predicted to experience significant bleeding. This method can reduce allogeneic transfusions as well as its associated risks ...

    Abstract Aim: Intraoperative cell salvage and autotransfusion (ICSA) is a useful technique for women undergoing cesarean sections who are predicted to experience significant bleeding. This method can reduce allogeneic transfusions as well as its associated risks and costs. Amniotic fluid embolism (AFE) is an abnormal maternal response to ICSA similar to the classic systemic inflammatory response syndrome, but its mechanism is not well understood. This study was conducted to investigate the biochemical aspects of AFE.
    Methods: A prospective case-controlled pilot study was conducted in a general perinatal hospital in Japan. ICSA was performed using a two-step retransfusion process. Blood samples were collected presurgery, immediately postsurgery, and 24 h after surgery. Changes in sialyl Tn antigen (STN), complement C3 and C4, fibrinogen, and fibrin degradation product and D-dimer, C1 esterase inhibitor, and interleukin-8 (all considered AFE-related markers) activities were compared between patients who underwent cesarean sections with ICSA (ICSA group) versus without ICSA (control group).
    Results: Fibrinogen levels were significantly lower in the ICSA group than in the control group before surgery but not immediately after or 24 h after surgery. D-dimer was significantly higher immediately after surgery but not 24 h later. STN was significantly lower only before surgery. None of the AFE-related markers showed significant differences between the groups after 24 h. No adverse events were observed in the ICSA group.
    Conclusions: There is no clinical evidence that ICSA alters the biochemical statuses of AFE-related markers in a manner that could lead to adverse maternal responses.
    MeSH term(s) Blood Transfusion, Autologous ; Case-Control Studies ; Cesarean Section/adverse effects ; Embolism, Amniotic Fluid ; Female ; Humans ; Japan ; Pilot Projects ; Pregnancy ; Prospective Studies
    Language English
    Publishing date 2021-03-14
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1327307-3
    ISSN 1447-0756 ; 1341-8076
    ISSN (online) 1447-0756
    ISSN 1341-8076
    DOI 10.1111/jog.14738
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: iPREFACE score: Integrated score index to predict fetal acidemia by intrapartum fetal heart rate monitoring.

    Ito, Ayumu / Hayata, Eijiro / Nakata, Masahiko / Oji, Ayako / Furukawa, Takamasa / Nakakuma, Masahito / Morita, Mineto

    The journal of obstetrics and gynaecology research

    2021  Volume 47, Issue 4, Page(s) 1305–1311

    Abstract: Aim: Cardiotocography is used worldwide to evaluate fetal well-being during pregnancy and labor. In past guidelines, the management plan was determined based on the assessment of the most severe waveform. There are no guidelines for evaluating the ... ...

    Abstract Aim: Cardiotocography is used worldwide to evaluate fetal well-being during pregnancy and labor. In past guidelines, the management plan was determined based on the assessment of the most severe waveform. There are no guidelines for evaluating the integrated recurrent decelerations; however, we believe their assessment to be essential for predicting the status of the fetus. The objective of this study was to propose an indicator for performing medical interventions during labor by creating a scoring system that reflects integrated recurrent decelerations.
    Methods: In this retrospective cohort study, we included data for only full-term single fetus births from vaginal deliveries. The score named the iPREFACE score (integrated score index to predict fetal acidemia by intrapartum fetal heart rate monitoring) was calculated using cardiotocography findings from continuing 30 min before delivery. We examined the iPREFACE score and fetal acidemia association and calculated the cut-off iPREFACE scores for acidemia using receiver operating characteristic curves.
    Results: The study included 469 delivery cases. Their iPREFACE scores exhibited a significant negative correlation with the umbilical artery blood pH (correlation coefficient; -0.43). The cut-off iPREFACE scores for the umbilical artery blood with pH <7.20, <7.10 and <7.0 were 44, 46 and 67, respectively (the areas under the curve were 0.776, 0.962 and 0.996, respectively).
    Conclusion: The iPREFACE score may predict fetal acidemia and could be used as an indicator for timely medical interventions during labor. Because assessments using a cardiotocography are quick and easy to perform, the iPREFACE score could be a valuable tool in clinical practice.
    MeSH term(s) Acidosis/diagnosis ; Cardiotocography ; Female ; Fetal Blood ; Fetal Diseases/diagnosis ; Fetal Monitoring ; Heart Rate, Fetal ; Humans ; Male ; Pregnancy ; Retrospective Studies
    Language English
    Publishing date 2021-01-12
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1327307-3
    ISSN 1447-0756 ; 1341-8076
    ISSN (online) 1447-0756
    ISSN 1341-8076
    DOI 10.1111/jog.14652
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  7. Article ; Online: Optimal duration of cardiotocography assessment using the iPREFACE score to predict fetal acidemia.

    Ito, Ayumu / Hayata, Eijiro / Nagasaki, Sumito / Kotaki, Hikari / Shimabukuro, Makiko / Sakuma, Junya / Takano, Mayumi / Oji, Ayako / Maemura, Toshimitsu / Nakata, Masahiko

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 13064

    Abstract: Cardiotocography (CTG) applicability to improve fetal outcomes remains controversial. This study aimed to determine the clinically optimal CTG assessment duration using the integrated score index to predict fetal acidemia by intrapartum fetal heart rate ... ...

    Abstract Cardiotocography (CTG) applicability to improve fetal outcomes remains controversial. This study aimed to determine the clinically optimal CTG assessment duration using the integrated score index to predict fetal acidemia by intrapartum fetal heart rate monitoring (iPREFACE score). This single-center, retrospective observational study included 325 normal full-term singleton vaginal deliveries at the Toho University Omori Medical Center, from September 2018 to March 2019. The iPREFACE(10), iPREFACE(30), and iPREFACE(60) scores were calculated at 10, 30, and 60 min immediately before delivery. The primary outcome was fetal acidemia (umbilical artery blood pH < 7.2). The secondary outcome was the correlation between all iPREFACE scores and the umbilical artery blood pH, base excess (BE), and lactate values. Patients without accurate CTG findings or with failure of umbilical artery blood sampling immediately after birth were excluded, leaving 145 patients in the final analysis. Of these, 16, three, and two had umbilical artery blood pH of < 7.2, < 7.1, and < 7.0, respectively. All iPREFACE scores significantly correlated with umbilical artery blood pH, BE, and lactate values. iPREFACE(30) had the highest predictive capacity for fetal acidemia, suggesting that 30 min immediately before delivery may be a useful scoring time in clinical practice.
    MeSH term(s) Acidosis ; Cardiotocography ; Female ; Fetal Blood ; Fetal Diseases ; Heart Rate, Fetal ; Humans ; Lactates ; Pregnancy ; Umbilical Arteries/diagnostic imaging
    Chemical Substances Lactates
    Language English
    Publishing date 2022-07-29
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-17364-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Apixaban therapy in a pregnant woman with heparin-induced thrombocytopenia and venous thromboembolic events caused by congenital antithrombin deficiency: A case report.

    Komori, Mayuko / Hayata, Eijiro / Nakata, Masahiko / Yuzawa, Hitomi / Oji, Ayako / Morita, Mineto

    Case reports in women's health

    2020  Volume 27, Page(s) e00200

    Abstract: We report the case of a 35-year-old pregnant woman (gravida 3, para 1) with antithrombin deficiency who was successfully treated with apixaban. She had a history of heparin-induced thrombocytopenia and venous thromboembolic events. Pregnancy was ... ...

    Abstract We report the case of a 35-year-old pregnant woman (gravida 3, para 1) with antithrombin deficiency who was successfully treated with apixaban. She had a history of heparin-induced thrombocytopenia and venous thromboembolic events. Pregnancy was confirmed while the patient was having anticoagulant therapy for a persistent thrombus. Choice of anticoagulation during her pregnancy was limited because of her antithrombin deficiency: heparin was not an option because of her history of heparin-induced thrombocytopenia; antithrombin-dependent anticoagulant drugs were not an option because of her antithrombin deficiency, and she preferred outpatient management. Despite the fact that there are no reports of its use in pregnant women, we selected apixaban (10 mg/day), a direct Xa inhibitor, as the best solution. No progression of thrombus was noted during the pregnancy. The newborn baby had no external congenital anomalies, intracranial hemorrhage, or bleeding tendency. Thus, apixaban may be a candidate for anticoagulant therapy in pregnant women with a history of venous thromboembolic events and heparin-induced thrombocytopenia.
    Language English
    Publishing date 2020-04-03
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2800286-6
    ISSN 2214-9112 ; 2214-9112
    ISSN (online) 2214-9112
    ISSN 2214-9112
    DOI 10.1016/j.crwh.2020.e00200
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  9. Article ; Online: High maternal mortality rate associated with advanced maternal age in Japan.

    Tanaka, Hiroaki / Hasegawa, Junichi / Katsuragi, Shinji / Tanaka, Kayo / Arakaki, Tatsuya / Nakamura, Masamitsu / Hayata, Eijiro / Nakata, Masahiko / Murakoshi, Takeshi / Sekizawa, Akihiko / Ishiwata, Isamu / Ikeda, Tomoaki

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 12918

    Abstract: This study aimed to clarify the relationship between maternal mortality and advanced maternal age in Japan and to provide useful information for future perinatal management. Maternal death rates by age group were investigated for all maternal deaths in ... ...

    Abstract This study aimed to clarify the relationship between maternal mortality and advanced maternal age in Japan and to provide useful information for future perinatal management. Maternal death rates by age group were investigated for all maternal deaths in Japan for an 11-year period, from 2010 to 2021. Maternal deaths among those aged ≥ 40 years were examined in detail to determine the cause, and the number of deaths by cause was calculated. The causes of onset of the most common causes of death were also investigated. The maternal mortality rates were 0.8 (95% confidence interval [CI] 0.3-4.7) for < 20 years, 2.6 (95% CI 1.7-3.8) for 20-24 years, 2.9 (95% CI 2.3-3.6) for 25-29 years, 3.9 (95% CI 3.3-4.5) for 30-34 years, 6.8 (95% CI 5.9-7.9) for 35-39 years, and 11.2 (95% CI 8.8-14.3) for ≥ 40 years of age. Patients who were ≥ 40 years of age had a significantly higher mortality rate compared to that in other age groups. Hemorrhagic stroke was the most common cause of death in patients aged ≥ 40 years (15/65 [23%]), and preeclampsia (8/15 [54%]) was the most common cause of hemorrhagic stroke. Maternal mortality is significantly higher in older than in younger pregnant women in Japan, with hemorrhagic stroke being the most common cause of maternal death among women > 40 years of age. More than half of hemorrhagic strokes are associated with hypertension disorder of pregnancy. These facts should be considered by women who become pregnant at an advanced age and by healthcare providers involved in their perinatal care.
    MeSH term(s) Pregnancy ; Humans ; Female ; Aged ; Adult ; Maternal Age ; Maternal Death ; Maternal Mortality ; Hemorrhagic Stroke ; Japan/epidemiology
    Language English
    Publishing date 2023-08-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-40150-4
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  10. Article: Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan.

    Tanaka, Hiroaki / Hasegawa, Junichi / Katsuragi, Shinji / Tanaka, Kayo / Arakaki, Tatsuya / Nakamura, Masamitsu / Hayata, Eijiro / Nakata, Masahiko / Sekizawa, Akihiko / Ishiwata, Isamu / Ikeda, Tomoaki

    Journal of clinical medicine

    2023  Volume 12, Issue 8

    Abstract: Background: Unlike Europe and the United States, Japan has seen numerous maternal deaths from hemorrhagic strokes related to hypertensive disorders of pregnancy (HDP). This study retrospectively analyzed deaths associated with HDP-related hemorrhagic ... ...

    Abstract Background: Unlike Europe and the United States, Japan has seen numerous maternal deaths from hemorrhagic strokes related to hypertensive disorders of pregnancy (HDP). This study retrospectively analyzed deaths associated with HDP-related hemorrhagic stroke in Japan to determine the number of deaths that may have been prevented with blood pressure control during pregnancy.
    Methods: This study included maternal deaths related to hemorrhagic stroke cases. The proportion of patients without proteinuria whose blood pressure exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation were determined. Lastly, the application of tight antihypertensive management was evaluated.
    Results: Among 34 HDP-related maternal deaths, 4 cases involved patients without proteinuria whose blood pressures exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation. These included two chronic hypertension and two gestational hypertension cases. None of the patients received antihypertensive agents, and their blood pressures were managed leniently.
    Conclusion: Among HDP-related hemorrhagic stroke deaths in Japan, only a few cases of maternal death could have been prevented with tight blood pressure management, as described in the CHIPS randomized controlled trial. Therefore, to prevent HDP-related hemorrhagic stroke in Japan, new preventive strategies during pregnancy should be established.
    Language English
    Publishing date 2023-04-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12082908
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