Annual report of Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2013: Development of Perinatal Emergency Care Systems and Suggestions

Placetal abruption is a disease occurring irrespective of the time and location and requiring maternal-fetal emergency care, so early delivery is indispensable, and the time from the occurrence of placental abruption to delivery should be shortened as much as possible

Annual report of Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2013: Development of Perinatal Emergency Care Systems and Suggestions

Placetal abruption is a disease occurring irrespective of the time and location and requiring maternal-fetal emergency care, so early delivery is indispensable, and the time from the occurrence of placental abruption to delivery should be shortened as much as possible

Annual report of Subcommittee for Examination of Causes of Maternal Death and their Prevention in Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2013

As the fibrinogen level decreases early in atonic bleeding, early administration of FFP may be important as an initial approach to treat atonic bleeding.Amniotic fluid embolism is classified into 2 types, conventional type and uterus-type

Sphingosine 1-Phosphate (S1P) in the Peritoneal Fluid Skews M2 Macrophage and Contributes to the Development of Endometriosis

Sphingosine 1-phosphate (S1P), an inflammatory mediator, is abundantly contained in red blood cells and platelets. We hypothesized that the S1P concentration in the peritoneal cavity would increase especially during the menstrual phase due to the reflux of menstrual blood, and investigated the S1P concentration in the human peritoneal fluid (PF) from 14 non-endometriosis and 19 endometriosis patients. Although the relatively small number of samples requires caution in interpreting the results, S1P concentration in the PF during the menstrual phase was predominantly increased compared to the non-menstrual phase, regardless of the presence or absence of endometriosis. During the non-menstrual phase, patients with endometriosis showed a significant increase in S1P concentration compared to controls. In vitro experiments using human intra-peritoneal macrophages (MΦ) showed that S1P stimulation biased them toward an M2MΦ-dominant condition and increased the expression of IL-6 and COX-2. An in vivo study showed that administration of S1P increased the size of the endometriotic-like lesion in a mouse model of endometriosis

MULTIFRACTAL ANALYSIS OF HEART RATE VARIABILITY IN NORMAL AND GROWTH-RESTRICTED FETUSES

Multifractal analysis has recently been validaded as an excellent method by which to analyze heart rate variability and in distinguishing healthy subjects from patients with various types of the cardiac nervous system dysfunction. Our objective was to improve the understanding of the multifractal properties of fetal heart rate (FHR) variability in healthy normal fetuses according to gestational age, and to determine whether the heart rate dynamics in growth-restricted fetuses is different from normal fetuses by multifractal analysis. One hundred nineteen FHR recordings obtained from healthy normal fetuses and 68 recordings obtained from small-for-gestational-age (SGA) fetuses were analyzed to examine gestational and pathologic changes of the degree of multifractality. A significant decrease was observed in the degree of multifractality of healthy normal fetuses according to gestational age. The degree of multifractality of SGA fetuses was significantly higher than that of healthy normal fetuses. Moreover, the degree of multifractality of complicated SGA fetuses who ultimately showed nonreassuring FHR patterns was significantly higher than that of uncomplicated SGA fetuses. And the latter was significantly higher than that of healthy normal fetuses. The degree of multifractality appears to be a sensitive probe for detecting subtle, and possibly important, changes that occur in fetuses with intrauterine growth restriction (IUGR), and may be helpful in the early and non-invasive detection of placental insufficiency or incipient IUGR. The mechanisms underlying FHR regulation in IUGR fetuses seem to be different from those of cardiac pathology in adults. </jats:p

Pregnancy outcomes of women exposed to laninamivir during pregnancy

Purpose The purpose of this study is to assess pregnancy outcomes of women treated with a novel neuraminidase inhibitor, laninamivir, during pregnancy. Methods A retrospective review of pregnancy outcomes of 112 pregnant women who were given laninamivir for treatment of influenza was performed. Possible adverse events, including miscarriages, preterm birth, foetal malformation and any neonatal morbidity requiring treatment, were assessed. Results Seventeen, 39, 46 and 10 women were administered a single inhaled dose of 20 or 40 mg of laninamivir at gestational week (GW) 3-11, 12-21, 22-36 and 37 or more, respectively. One (1.8%) of 56 women with laninamivir at GW <22 experienced miscarriage at GW <12. The remaining 111 women gave birth to 111 viable infants but at preterm (GW <37) in nine (8.8%) of 102 women with laninamivir at GW <37. Three (2.7%) of the 111 newborns had malformations: forefoot varus deformity, foot polydactyly and cleft lip in one each born to a mother taking laninamivir atGW6, 17 and 21, respectively. Five neonates (4.5%) were small for gestational age. Eleven (9.9%), five (4.5%) and no neonates required phototherapy for jaundice, transient respiratory supports for respiratory distress syndrome (n = 2) or transient tachypnoea of the newborn (n = 3), and glucose administration for hypoglycaemia, respectively. Conclusions Although this study included a small number of study women and no control women, the results suggested that maternal exposure to laninamivir did not increase the rate of adverse pregnancy and foetal outcomes. (C) 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd