Efficacy of expectant management of severe preeclampsia and preeclampsia superimposed on chronic hypertension before 34 weeks gestation.

Objectives: To investigate the effect of chronic hypertension on expectant management for preeclampsia (PE).

Study Design: Pregnant women who were diagnosed with severe PE before 34 weeks of gestation between 2005 and 2016 and managed at a tertiary center were the subjects of the study. Mothers were classified into two groups: a severe superimposed PE (SSP) group and a severe PE (SP) group.

Antenatal Administration of Betamethasone Contributes to Intimal Thickening of the Rat Ductus Arteriosus.

Background: Antenatal betamethasone (BMZ) is a standard therapy for reducing respiratory distress syndrome in preterm infants. Recently, some reports have indicated that BMZ promotes ductus arteriosus (DA) closure. DA closure requires morphological remodeling; that is, intimal thickening (IT) formation; however, the role of BMZ in IT formation has not yet been reported.

Safety and efficacy of DTaP-IPV vaccine use in healthcare workers for prevention of pertussis.

Pertussis can be fatal for infants. The best way to prevent infant pertussis is to promote adult immunization. However, Tdap has not been licensed in Japan, so we investigated the effect and safety of the DTaP-IPV vaccine instead.

Placenta Accreta following Hysteroscopic Lysis of Adhesions Caused by Asherman's Syndrome: A Case Report and Literature Review.

Asherman's syndrome is defined as partial or complete obstruction of the uterine cavity primarily caused by intrauterine procedures and infections. Hysteroscopic adhesiolysis is commonly used to treat Asherman's syndrome. Although the frequency of placenta accreta is known to increase with pregnancy after hysteroscopic adhesiolysis, precise data remain unknown.

Clinical significance of low result of 1-h 50-g glucose-challenge test in pregnant women.

Objective: The objective of this study is to examine the effect of low-glucose value on the 1-h 50-g glucose challenge test (GCT) on neonatal body weight in low-risk Asian singleton pregnant women.

Method: We retrospectively analyzed women who delivered a singleton neonate at term at a tertiary center and underwent GCT at 24-28 weeks of gestation between June 2001 and June 2015. The low GCT group was defined as <75 mg/dL and 75-139 mg/dL were control.

Incidence and pregnancy outcomes of superimposed preeclampsia with or without proteinuria among women with chronic hypertension.

Objective: To investigate the incidence and pregnancy outcomes of superimposed preeclampsia (PE) with or without proteinuria among women with chronic hypertension.

Methods: This retrospective study included 142 women with essential hypertension diagnosed at ⩽20weeks of gestation, managed at a tertiary center. They were divided into three groups (non-PE, PE with proteinuria, and PE without proteinuria) to compare pregnancy outcomes.

Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum Hemorrhage with Disseminated Intravascular Coagulation.

Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared.

Glutamate Promotes Contraction of the Rat Ductus Arteriosus.

Background: Extremely preterm infants frequently have patent ductus arteriosus (PDA). Recent recommendations include immediately beginning amino acid supplementation in extremely preterm infants. However, the effect of amino acids on closure of the ductus arteriosus (DA) remains unknown.

Spontaneous reduction of an incarcerated gravid uterus in the third trimester.

An incarcerated gravid uterus is an uncommon complication of pregnancy. On rare occasions, an incarcerated gravid uterus resolves spontaneously even in the third trimester of pregnancy. Severe abdominal pain might be caused by spontaneous reduction and should be considered as a possible cause.

Preterm premature rupture of membrane after polypectomy using an Endoloop polydioxanone suture II(™).

Polypectomy using an Endoloop PDS II (™) during pregnancy can be responsible for miscarriage and preterm delivery. Cervical polyps should not be removed in pregnant women except in cases where a malignancy is suspected.

A monochorionic diamniotic twin pregnancy requiring termination due to maternal anemia caused by bleeding from chronic abruption.

In patients with bloody amniotic fluid, expectant management for chronic abruption is difficult and should not be applied except after a 48-h waiting period required for administration of steroids.

Relationship Between Short Umbilical Cord Length and Adverse Pregnancy Outcomes.

To investigate how umbilical cord length relates to pregnancy outcomes, we retrospectively analyzed data from 89,042 deliveries recorded in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System. We included term deliveries in which vaginal birth was attempted. Umbilical cord length was categorized into four groups: less than the first percentile, from the first percentile to less than the 10th percentile, from the 10th percentile to less than 25th percentile, and from the 25th percentile to less than the 75th percentile, which constituted the control group.

Decreased serum osmolality promotes ductus arteriosus constriction.

Aims: At birth, dynamic changes occur in serum components and haemodynamics, such as closure of the ductus arteriosus (DA). A previous study demonstrated that, in full-term human neonates, serum osmolality decreased transiently after birth, but recovered over the next few days. However, the significance of this transient decrease in osmolality has never been addressed.

Immune response to Haemophilus influenzae type b conjugate vaccine in preterm infants.

Background: Haemophilus influenzae type b (Hib) vaccine became available for use in Japan in December 2008. The aim of the present study was to evaluate the immunogenicity of Hib vaccine in Japanese preterm infants.

Methods: Serum samples were obtained from 54 preterm infants before the first vaccination and 1 month after the third.

Urinary ß2-microglobulin in very preterm neonates with chorioamnionitis.

It is important to identify premature infants with prenatal inflammation as it contributes to short- and long-term complications. Our object was to study how prenatal inflammation affects the urinary β(2)-microglobulin (β(2)-MG) level. Preterm neonates were divided based on the presence of chorioamnionitis (CAM) into the CAM (n = 100) and non-CAM groups (n = 117).

Severity of chorioamnionitis and neonatal outcome.

Aim: The aim of this study is to elucidate whether the stage of chorioamnionitis is or is not associated with the development of neonatal diseases.

Material & Methods: We reviewed the neonatal intensive care unit discharge files and placental pathology reports of 302 preterm infants. The presence of various stages of chorioamnionitis as well as absence of an association with chorioamnionitis (non-chorioamnionitis) were compared among neonatal diseases.

Early discharge from a neonatal intensive care unit and rates of readmission.

Background: Increasing admissions to neonatal intensive care units (NICUs) demand early discharge from the units. Our hospital aims to early discharge patients who meet the following requirements: they are able to regulate body temperature; neither apnea nor bradycardia is observed; and bodyweight increases with lactation. We studied the real state of this strategy.

Soluble tumor necrosis factor receptor-1 in preterm infants with chronic lung disease.

Background: It is clear that inflammation plays an important role in developing chronic lung disease in preterm infants. The purpose of the present study is to investigate changes of serum soluble tumor necrosis factor receptor-1 levels over time in infants with chronic lung disease.

Methods: The serum levels of soluble tumor necrosis factor receptor-1 were measured after delivery, and at 7, 14, 21 and 28 days of age in 10 infants with chronic lung disease and in 18 infants without chronic lung disease.

Soluble tumor necrosis factor receptor-I in preterm infants with chorioamnionitis.

Aim: The aim of our study was (i) to determine whether chorioamnionitis (CAM) is associated with an elevated soluble tumor necrosis factor receptor I (sTNFR-I) level and (ii) to examine the time course of the concentration of sTNFR-I in preterm infants after birth.

Methods: We measured sTNFR-I levels in the cord blood of 112 preterm infants (gestational age < or =34 weeks), and those in peripheral blood of 30 preterm infants on days 7, 14, 21 and 28.

Results: The median value for the sTNFR-I was significantly elevated in 33 infants with CAM at stage 3 (4618 pg/mL) compared with the 52 infants without CAM (2866 pg/mL), or the 13 infants with CAM at stage 1 (3638 pg/mL) and the 14 infants at stage 2 (3242 pg/mL).

Blood flow velocities in the anterior cerebral artery and basilar artery in asphyxiated infants.

Objective: The aim of this series was to determine whether cerebral blood flow velocities (CBFVs) in the anterior cerebral artery (ACA) and basilar artery (BA) correlate with the severity of asphyxia in infants and whether these velocity measures can be useful for predicting early developmental prognosis.

Methods: We measured CBFVs in the ACA and BA by using pulsed Doppler sonography in 29 healthy and 17 asphyxiated infants (11 with mild asphyxia [median gestational age, 38 weeks; median birth weight, 2856 g] and 6 with severe asphyxia [38.5 weeks; 2910 g]).

Interleukin-6, interleukin-8, and soluble tumor necrosis factor receptor-I in the cord blood as predictors of chronic lung disease in premature infants.

Objectives: In order to predict the late-development of chronic lung disease of prematurity (CLD), cytokines in the cord blood were assessed in this study.

Study Design: Eighteen premature infants with CLD were enrolled. Cord blood plasma levels of cytokines of these infants and 12 control infants without CLD were measured including interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, soluble TNF receptor-I, and soluble IL-6 receptor using a cytometric bead array and an enzyme-linked immunosorbent assay.

Hemimegalencephaly misdiagnosed as a congenital brain tumor by fetal cerebral ultrasonography.

Objective: To describe a case of hemimegalencephaly misdiagnosed prenatally.

Case Report: We presented a neonate with hemimegalencephaly, who was thought to have a congenital brain tumor by fetal cerebral ultrasonography. Postnatal MRI findings showed hemimegalencephaly characterized by mild enlargement of the affected hemisphere with a predominantly abnormal signal in the frontal lobe.

Urinary beta 2-microglobulin in premature infants with chorioamnionitis and chronic lung disease.

The urinary beta(2)-microglobulin (MG) concentration on day 0 to 2 was significantly higher in premature infants with chorioamnionitis (CAM) than in infants without CAM and in infants who developed chronic lung disease (CLD) than in those who did not. We propose that an elevated urinary beta(2)-MG can indicate a fetal inflammatory response and identify neonates at risk for the development of CLD.