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  1. Article ; Online: Effect of epidural analgesia on cervical ripening using dinoprostone vaginal inserts.

    Hasegawa, Junichi / Homma, Chika / Saji, Shota / Furuya, Natsumi / Sakamoto, Miki

    Journal of anesthesia

    2024  Volume 38, Issue 2, Page(s) 215–221

    Abstract: Objective: To clarify whether the duration from cervical ripening induction to labor onset is prolonged when epidural analgesia is administered following application of dinoprostone vaginal inserts vs. cervical ripening balloon.: Methods: This ... ...

    Abstract Objective: To clarify whether the duration from cervical ripening induction to labor onset is prolonged when epidural analgesia is administered following application of dinoprostone vaginal inserts vs. cervical ripening balloon.
    Methods: This retrospective study included mothers with singleton deliveries at a single center between 2020-2021. Nulliparous women who underwent labor induction and requested epidural analgesia during labor after 37 weeks of gestation were included. The duration from cervical ripening induction to labor onset was compared between women using a dinoprostone vaginal insert and those using a cervical ripening balloon and between women who received epidural analgesia before and after labor onset.
    Results: In the dinoprostone vaginal insert group, the duration was significantly shorter in the subgroup that received epidural analgesia after labor onset (estimated median, 545 [95% confidence interval: 229-861 min]) than the subgroup that received it before labor onset (estimated median, 1,570 [95% confidence interval: 1,226-1,914] min, p = 0.004). However, in the cervical ripening balloon group, the difference between subgroups was not significant. The length of labor among the groups was also not significantly different.
    Conclusion: Epidural analgesia as labor relaxant adversely affected the progression of uterine cervical ripening when dinoprostone vaginal inserts were used, whereas it did not affect cervical ripening when a mechanical cervical dilatation balloon was used. The present results are significant for choosing the appropriate ripening method.
    MeSH term(s) Pregnancy ; Female ; Humans ; Dinoprostone/pharmacology ; Oxytocics ; Retrospective Studies ; Analgesia, Epidural ; Cervical Ripening ; Labor, Induced/methods
    Chemical Substances Dinoprostone (K7Q1JQR04M) ; Oxytocics
    Language English
    Publishing date 2024-02-01
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1107821-2
    ISSN 1438-8359 ; 0913-8668
    ISSN (online) 1438-8359
    ISSN 0913-8668
    DOI 10.1007/s00540-023-03307-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Ectopic uterine cervical ripening dilator.

    Hasegawa, Junichi / Nishimura, Yoko / Saji, Shota

    Journal of medical ultrasonics (2001)

    2023  Volume 51, Issue 1, Page(s) 145–146

    MeSH term(s) Pregnancy ; Female ; Humans ; Cervical Ripening ; Cervix Uteri/diagnostic imaging
    Language English
    Publishing date 2023-09-16
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1396630-3
    ISSN 1613-2254 ; 0287-0592 ; 1346-4523
    ISSN (online) 1613-2254
    ISSN 0287-0592 ; 1346-4523
    DOI 10.1007/s10396-023-01361-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Ultrasound Doppler Findings in Fetal Vascular Malperfusion Due to Umbilical Cord Abnormalities: A Pilot Case Predictive for Cerebral Palsy.

    Saji, Shota / Hasegawa, Junichi / Koike, Junki / Takatsuki, Misato / Furuya, Natsumi / Suzuki, Nao

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 18

    Abstract: Fetal Vascular Malperfusion (FVM), a pathologic condition in the feto-placental circulation, is a chronic vaso-occlusive disorder in the umbilical venous blood flow. Microthrombi are caused by the umbilical cord's blood flow deficiency in a congested ... ...

    Abstract Fetal Vascular Malperfusion (FVM), a pathologic condition in the feto-placental circulation, is a chronic vaso-occlusive disorder in the umbilical venous blood flow. Microthrombi are caused by the umbilical cord's blood flow deficiency in a congested umbilical vein, which also causes microvascular damage to fetal organs, especially the brain, resulting in cerebral palsy. Thrombo-occlusive events also adversely affect the upstream chorionic or stem vessels in the placenta, resulting in fetal growth restriction and fetal hypoxia. An umbilical cord structural anomaly or multiple entanglements may involve FVM. In the present report, we demonstrate a case of FVM caused by multiple umbilical cord abnormalities obtained from antenatal ultrasound Doppler findings, and we also discuss FVM, which is chronically associated with CP, comparing the ultrasonographic findings to the pathologic findings.
    Language English
    Publishing date 2023-09-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13182977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Optimal cervical-ripening method for labor induction in Japan after the era of controlled-release dinoprostone vaginal insert.

    Furuya, Natsumi / Hasegawa, Junichi / Saji, Shota / Homma, Chika / Nishimura, Yoko / Suzuki, Nao

    The journal of obstetrics and gynaecology research

    2023  Volume 50, Issue 1, Page(s) 40–46

    Abstract: Objective: To investigate the predictive value of obstetric findings when using dinoprostone (prostaglandin E2 [PGE2]) vaginal inserts for cervical ripening, and to assess the optimal cervical-ripening method between PGE2 vaginal insert and/or cervical ... ...

    Abstract Objective: To investigate the predictive value of obstetric findings when using dinoprostone (prostaglandin E2 [PGE2]) vaginal inserts for cervical ripening, and to assess the optimal cervical-ripening method between PGE2 vaginal insert and/or cervical dilators.
    Methods: This prospective observational study enrolled pregnant women who underwent cervical ripening for labor induction in 37-41 week' gestation in 2020. In evaluation 1, optimal obstetric findings predictive of rapid cervical ripening using PGE2 were assessed. In evaluation 2, the duration from PGE2 administration to labor onset and perinatal outcomes were compared between cases in which only PGE2 was used and cases that were treated with PGE2 after mechanical cervical dilators (Dilapan®) for extremely immature cervical ripening (uterine cervical os <2 cm).
    Results: In evaluation 1, uterine dilatation before the use of a PGE2 vaginal insert was mostly correlated with the time from PGE2 administration to labor onset (r = -0.428, p < 0.001). When the uterine cervical os dilatation was ≥2 cm, a shorter time-to-labor onset was found. In addition, os dilatation, effacement, and station at the time of PGE2 vaginal insert removal also significantly progressed. In evaluation 2, the median duration from PGE2 administration to labor onset was 1740 min in cases where only PGE2 was used, and 610 min in those where PGE2 was used after mechanical cervical dilators (p = 0.011).
    Conclusion: PGE2 vaginal inserts are relatively effective when the uterine cervical os is ≥2 cm in diameter. However, in cases of extremely immature cervical-ripening, it was feasible to use PGE2 vaginal inserts before mechanical cervical dilatation.
    MeSH term(s) Female ; Pregnancy ; Humans ; Dinoprostone/pharmacology ; Oxytocics/pharmacology ; Cervical Ripening ; Delayed-Action Preparations ; Japan ; Labor, Induced/methods ; Administration, Intravaginal
    Chemical Substances Dinoprostone (K7Q1JQR04M) ; Oxytocics ; Delayed-Action Preparations
    Language English
    Publishing date 2023-10-11
    Publishing country Australia
    Document type Observational Study ; Journal Article
    ZDB-ID 1327307-3
    ISSN 1447-0756 ; 1341-8076
    ISSN (online) 1447-0756
    ISSN 1341-8076
    DOI 10.1111/jog.15812
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Individualized management of vasa previa and neonatal outcomes.

    Saji, Shota / Hasegawa, Junichi / Oyelese, Yinka / Furuya, Natsumi / Homma, Chika / Nishimura, Yoko / Nakamura, Masamitsu / Suzuki, Nao

    The journal of obstetrics and gynaecology research

    2023  Volume 49, Issue 11, Page(s) 2680–2685

    Abstract: Objective: To describe our individualized management protocol for women with an antenatal diagnosis of vasa previa (VP) and to report maternal and neonatal outcomes in patients managed according to our protocol.: Methods: A retrospective study of ... ...

    Abstract Objective: To describe our individualized management protocol for women with an antenatal diagnosis of vasa previa (VP) and to report maternal and neonatal outcomes in patients managed according to our protocol.
    Methods: A retrospective study of prospectively collected data of antenatally diagnosed VP managed at our hospital between 2014 and 2021. Obstetric and neonatal outcomes were reviewed and analyzed.
    Results: Fourteen cases of antenatally diagnosed VP in 5150 total deliveries were analyzed (0.3%) Five cases (36%) of VP were diagnosed during the routine fetal morphological ultrasound screening, and nine cases (64%) were referred to our hospital due to perinatal complications. There were nine cases that required hospitalization (due to fetal growth restriction [FGR] [1], preterm labor [3], patients' request [5]). The other five were asymptomatic. Eight patients were delivered by scheduled cesarean section at around 36 weeks and only three neonates were admitted to NICU with transient tachypnea of newborn. However, six patients required CS before the scheduled dates because of other complications (preterm labor [3], abnormal cardiotocogram patterns [1], FGR [1] and twin pregnancy [1]). Four neonates born by CS before their scheduled dates were admitted to NICU. No cases required prolonged hospitalization and there were no serious neonatal complications.
    Conclusion: Individualized management may lead to favorable outcomes with VP. Outpatient management may be considered in patients without risk factors. However, maternal hospitalization and earlier scheduled CS should be considered in symptomatic patients or those at risk for preterm delivery.
    MeSH term(s) Infant, Newborn ; Pregnancy ; Female ; Humans ; Vasa Previa/diagnostic imaging ; Vasa Previa/therapy ; Retrospective Studies ; Cesarean Section ; Prenatal Diagnosis ; Ultrasonography, Prenatal ; Premature Birth
    Language English
    Publishing date 2023-08-24
    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.15775
    Database MEDical Literature Analysis and Retrieval System OnLINE

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