Language：English   Publishing type：Research paper (scientific journal)  

AIM: To analyze temporal trends and regional variations in operative vaginal delivery (OVD) in Japan. METHODS: Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan from 2014 to 2021, we identified the numbers of vacuum and forceps deliveries. We analyzed annual totals and proportions of OVDs and calculated the mean age of women undergoing these deliveries. We also predicted trends in OVD for the next 20 years and compared geographical differences in the proportions of forceps deliveries among OVDs. RESULTS: During the observation period, out of 7 368 814 total births, 8.4% were through OVD, including 7.6% by vacuum and 0.8% by forceps. Both delivery methods showed an increasing trend from 2014 to 2021: vacuum deliveries rose from 7.0% to 8.7%, and forceps deliveries increased from 0.6% to 1.0%. Notably, the proportion of forceps deliveries in OVD increased from 8.1% to 10.5%. The mean age was higher for forceps deliveries than vacuum deliveries. According to our predictions, vacuum deliveries may continue to increase, but forceps deliveries may stabilize. The proportion of forceps deliveries among OVDs ranged from 0% to 38% across Japanese prefectures. CONCLUSIONS: This study shows an increase in the use of OVD in Japan from 2014 to 2021. There are large regional differences in the choice between vacuum and forceps deliveries. These findings can help us understand the practice of OVD in Japan.

DOI： 10.1111/jog.16039

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10396-023-01404-w

PubMed

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Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

卵黄嚢腫瘍(YST)は稀に閉経後にも発生し,多くは上皮性腫瘍と混在し,組織学的に類似した明細胞癌との鑑別も重要となる.今回,組織学的診断に苦慮した症例を経験したため報告する.症例は67歳,突然の腹痛を伴う15cm大の多房性卵巣腫瘍で一部に充実部分を認め,血性腹水の出現とAFP,CA125,CA19-9の上昇を伴うことから,卵巣悪性腫瘍の破裂と診断して,緊急手術を行った.IC2期のYSTと診断し,速やかにBEP療法を開始し,1サイクル終了時にはAFPが陰性化した.閉経後のYSTであり,上皮性腫瘍由来の可能性を考慮して再検討を行った.腫瘍の主体となる粘液性腫瘍にはCDX2,p53が陽性で腸型粘液産生を認め,YSTを認めた充実部分では,AFP,SALL4,CDX2,p53が陽性でCK7,EMA,ARID1Aが陰性という所見であり,体細胞を起源として発生したYSTと診断した.BEP療法による重篤な骨髄抑制が出現し,2サイクル目以降はレジメンをTC療法に変更して治療を行い,術後17カ月時点において無再発で経過中である.近年,閉経後YSTは体細胞腫瘍が発生由来とされており,本症例も免疫組織化学の結果からsomatic YSTであることが推察された.閉経後のYSTでは,上皮性腫瘍との関連性を考慮した診断ならびに治療法選択が必要である.(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMC  

Background Our previous study demonstrated the safety and effectiveness of abdominal radical trachelectomy during pregnancy but did not focus on the fetus. This study aimed to clarify the influence of abdominal radical trachelectomy performed during pregnancy on the fetus. Methods Eight cervical cancer patients who underwent abdominal radical trachelectomy at our hospital between February 2013 and August 2020 were enrolled in this study. To assess the peri- and postoperative influence on the fetus, we performed fetal heart monitoring at 30-min intervals during abdominal radical trachelectomy and calculated the estimated fetal body weight and resistance indexes of the middle cerebral artery and umbilical artery from postsurgery until delivery. Results Four out of eight patients had preterm birth due to chorioamnionitis in one case and consideration of the recurrent risk of cervical cancer in three cases. Fetal heart monitoring during abdominal radical trachelectomy revealed deceleration just once in one case but no abnormal findings in the other cases. In all cases, the fetal growth after abdominal radical trachelectomy was normal until delivery. No abnormal Doppler findings were detected in the middle cerebral artery or umbilical artery. Conclusion Our findings clarified that abdominal radical trachelectomy performed for the treatment of early-stage cervical cancer during pregnancy has no obvious influence on fetal growth. Next, it is necessary to evaluate the growth and development of children delivered from mothers who have undergone abdominal radical trachelectomy during pregnancy.

DOI： 10.1186/s12884-022-04671-6

Web of Science

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Language：Japanese   Publisher：新潟産科婦人科学会  

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Language：Japanese   Publisher：日本産科婦人科学会  

CiNii Article

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Other Link： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=456837

Language：Japanese   Publisher：日本産科婦人科学会  

CiNii Article

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Other Link： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=450112

Language：Japanese   Publisher：日本産科婦人科学会  

CiNii Article

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Other Link： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=446402