論文 - 銘苅　桂子

Diffusion lacunae: a novel MR imaging finding on diffusion-weighted imaging for diagnosing placenta accreta spectrum.

Iraha Y, Fujii S, Tsuchiya N, Azama K, Yonamine E, Mekaru K, Kinjo T, Sekine M, Nishie A

Japanese journal of radiology     2024年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Out-of-pocket fertility preservation expenses: data from a Japanese nationwide multicenter survey.

Ono M, Takai Y, Harada M, Horie A, Dai Y, Kikuchi E, Miyachi M, Yamamoto T, Fujii N, Kajiyama H, Manabe A, Yasuoka T, Katsuragi S, Mekaru K, Maezawa T, Horage Y, Kataoka S, Nakayama R, Nakajima TE, Kimura F, Shimizu C, Sugimoto K, Takae S, Yumura Y, Nishi H, Furui T, Morishige KI, Watanabe C, Osuga Y, Suzuki N

International journal of clinical oncology ( International Journal of Clinical Oncology )    2024年09月 [ 査読有り ]

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How Effective Is Cervical Ripening Using the Controlled-Release Dinoprostone Vaginal Delivery System for Primiparas with Unruptured Membranes?

Yoshino Kinjyo* , Yukiko Chinen, Tadatsugu Kinjo, Shuko Chinen, Keiko Mekaru

Open Journal of Obstetrics and Gynecology     2024年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. Aims: To compare the effectiveness of a controlled-release dinoprostone vaginal delivery system for cervical dilatation (PROPESS) with that of mechanical dilation for labor induction in primiparous women with unruptured membranes. Materials and Methods: We retrospectively analyzed the data of 90 primiparas with unruptured membranes (41 and 49 in the PROPESS and mechanical dilation groups, respectively). The primary outcome was the cesarean section (CS) rate. The secondary outcomes were the prevalence of vaginal delivery within 12 or 24 h after the initial insertion, oxytocin usage rate, chorioamnionitis, additional use of mechanical dilation in the PROPESS group, and neonatal outcomes. Results: The CS rate was significantly lower in the PROPESS group than in the mechanical dilation group (p = 0.02). A total of 13 patients (31.7%) delivered within 24 h with PROPESS alone, indicating a significantly higher rate of delivery within 24 h in the PROPESS group (p = 0.02). Fewer patients required additional oxytocin in the PROPESS group than in the mechanical dilation group (p = 0.001). However, 14 (34%) patients in the PROPESS group required additional mechanical cervical dilation, resulting in a longer time to delivery than mechanical dilation. Conclusions: PROPESS significantly reduced CS rates and increased delivery rates 24 h after the initial insertion in primiparas with unruptured membranes compared to mechanical dilatation. However, failure to respond to PROPESS resulted in an overall longer delivery time than that of the conventional mechanical dilation group; therefore, identifying predictors of response to PROPESS is necessary.

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Relationship between the serum creatinine concentrations of preterm neonates within 24 h of birth and their mothers before delivery

Shimabukuro, W; Nakada, S; Shimada, K; Tsukayama, M; Hamada, K; Goya, H; Kinjo, N; Yoshida, T; Mekaru, K; Nakanishi, K

CLINICAL AND EXPERIMENTAL NEPHROLOGY ( Clinical and Experimental Nephrology )  28 ( 4 ) 293 - 299   2024年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Perinatal Morbidity, Mortality, and Neurodevelopmental Outcomes of Neonates with Fetal Growth Restriction

Natsuki Tamashiro, Shuko Chinen, Yoshino Kinjyo, Yukiko Chinen, Tadatsugu Kinjo, Keiko Mekaru

Open Journal of Obstetrics and Gynecology     2024年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Evaluation of brain development and damage using magnetic resonance imaging of congenital diaphragmatic hernia survivors: An analysis using the global brain abnormality score.

Yoshida T, Goya H, Tsukayama M, Kuda M, Yogi A, Mekaru K, Nakanishi K

Pediatrics and neonatology ( Pediatrics and Neonatology )  65 ( 2 ) 127 - 132   2024年03月 [ 査読有り ]

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Placenta Accreta Spectrum with Ureteral Invasion due to Progression of Cesarean Scar Pregnancy

Yara, N; Kinjyo, Y; Chinen, Y; Kinjo, T; Mekaru, K

CASE REPORTS IN OBSTETRICS AND GYNECOLOGY ( Case Reports in Obstetrics and Gynecology )  2023   9065978   2023年10月 [ 査読有り ]

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女性医師支援から働き方改革へ～ダイバーシティの実現は組織を変えるか～

銘苅 桂子

日本気管食道科学会会報 ( 特定非営利活動法人 日本気管食道科学会 )  74 ( 2 ) 173 - 175   2023年04月

掲載種別: 研究論文（学術雑誌）

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Vaginal Microbiota and Pregnancy Outcomes of Patients with Conization Histories.

Hashiramoto S, Kinjo T, Tanaka SE, Arai W, Shimada M, Ashikawa K, Sakuraba Y, Yuji O, Yara N, Kinjyo Y, Chinen Y, Nagai Y, Mekaru K, Aoki Y

Journal of women's health (2002) ( Journal of Women's Health )  32 ( 3 ) 375 - 384   2023年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: One of the major risks of preterm birth is a history of conization. However, the risk of infection due to this procedure is still not well known. Using next-generation sequencing, we aimed to reveal the influence of conization on vaginal microbiota in the following pregnancy, and their relationship between spontaneous preterm birth (sPTB). Methods: We conducted a prospective cohort study including 133 pregnant patients, of whom 25 had conization histories and 108 did not. Vaginal microbiome samples were collected using swabs by an obstetrician upon inclusion in the first trimester and during delivery. V1-V2 of the 16S rRNA gene were amplified and analyzed to identify the bacteria. Results: The conization group had a significantly lower delivery week (34 weeks vs. 36 weeks, p = 0.003) and higher sPTB rate (64% vs. 8.3%, p ≤ 0.001) than the control group. In the conization group, alpha (Chao 1, p = 0.02; phylogenetic diversity whole tree, p = 0.04) and beta diversity (permutational multivariate analysis of variance test, p = 0.04) of the vaginal microbiota was significantly higher during delivery in patients who delivered preterm than in those who delivered term. Community-state type IV in the first trimester was significantly associated with sPTB (overall odds ratio 3.80, 95% confidence interval 1.33-10.8, p = 0.01). Conclusions: Conization is a risk factor for sPTB. Increased risk of sPTB in patients after conization may belong to the vulnerable defense mechanism, due to the shortened cervix and decreased cervical mucus.

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Effect of the Concentration of Various Polyunsaturated Fatty Acids in Human Follicular Fluid on Oocyte Maturation and Fertilization

Keiko Mekaru*1, Misako Aoyama-Shimoji2, Rie Nakamura1, Sugiko Oishi1, Maho Miyagi1, Kozue Akamine1, Yoichi Aoki1

CEOS Obstetrics and Gynecology     2023年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Risk Factors of Preterm Birth in Okinawa Prefecture, the Southernmost Island Prefecture of Japan.

Kinjyo Y, Kinjo T, Mekaru K, Nagai Y, Moromizato T, Ohata T, Iseki C, Iseki K, Aoki Y

Maternal and child health journal ( Maternal and Child Health Journal )  27 ( 1 ) 92 - 100   2023年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVES: A high rate of preterm birth has been reported in Okinawa Prefecture, the southernmost island prefecture of Japan. Hence, this study aimed to identify the risk factors for preterm birth in this prefecture. METHODS: This retrospective study included data from January 2013 to December 2019 from three facilities in Okinawa Prefecture. Of 13,468 cases of preterm birth at ≥ 22 weeks of gestation, 11,868 were included in this study. Stillbirth and multiparity cases were excluded. First, we compared the overall preterm and full-term birth groups by categorizing the patient background, obstetric, and fetal risk factors. Further, we categorized preterm births into three groups (22-27, 28-33, and 34-36 weeks of gestation) and examined patient background factors to identify potential risk factors for the occurrence of preterm birth in each group. RESULTS: Preterm births accounted for 21.2% (2,521 cases) of all cases, with the rates of 2.6% (317 cases), 6.7% (800 cases), and 11.8% (1,404 cases) at 22-27, 28-33, and 34-36 weeks of gestation, respectively. To prevent preterm birth in Okinawa Prefecture, the present study specifically focused on patient background characteristics. In the multinomial logistic regression, the risk factors for preterm birth at 22-27 weeks of gestation were previous preterm birth (P < 0.0001) and lower age (P = 0.026); at 28-33 weeks of gestation, the risk factors were previous preterm birth (P < 0.0001) and history of cervical conization (P = 0.009); and at 34-36 weeks of gestation, only previous preterm birth (P < 0.0001) was a risk factor. CONCLUSIONS FOR PRACTICE: Previous preterm birth, younger age, and history of cervical conization were risk factors for Preterm birth in Okinawa. To reduce premature births in Okinawa Prefecture, it is important to pick up women with these risk factors and provide them with appropriate guidance and education on an ongoing basis.

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臨床におけるジノプロストン腟内留置の効果と注意点

銘苅 桂子

日本周産期・新生児医学会雑誌 ( 一般社団法人 日本周産期・新生児医学会 )  58 ( 4 ) 659 - 661   2023年

掲載種別: 研究論文（学術雑誌）

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<p>　<b>頸管熟化の機序とプロスタグランジン</b></p><p>　妊娠から分娩時にかけての頸管の変化は，軟化（softening），熟化・開大（ripening・dilation），分娩後の修復（post partum repair）からなり，これをCervical remodelingとよぶ^1）．子宮頸管は線維芽細胞，単球マクロファージなどの間質細胞，細胞外マトリクスにより構成され，正期産における子宮頸管の変化では，未熟コラーゲン線維やヒアルロナンの産生増加による水分含量の増加による熟化が起こる^1）．マウスの子宮頸管コラーゲン繊維断面の電子顕微鏡所見は，妊娠初期から後期にかけて，子宮頸管のマトリックスが劇的に変化することで，頸管が軟化していることを示している^2）．また，プロゲステロンの低下は頸管熟化や開大のため重要と考えられているが，マウスの頸管上皮ではプロゲステロンの代謝に必要なSteroid 5 alphareductase type 1（SRD5a1）の発現を認めると報告されている^2）．加えて，プロスタグランジン（PG）は子宮の収縮と頸管熟化の作用を有する．PGEの受容体にはEP1からEP4までの4つのサブタイプが存在し，EP1とEP3は子宮収縮作用，EP2とEP4は平滑筋弛緩作用により頸管熟化を促すとされる（図1）^3）．PGE2はEP1からEP4までのすべての受容体に作用することで，子宮収縮作用と頸管熟化作用の両方を有する．</p>

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特集 Controversies in perinatology 2023 産科編 出血を伴う胎盤遺残-TAE

金城 忠嗣, 銘苅 桂子

周産期医学 ( 東京医学社 )  52 ( 12 ) 1737 - 1740   2022年12月

掲載種別: 研究論文（学術雑誌）

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Endometrial and vaginal microbiomes influence assisted reproductive technology outcomes.

Miyagi M, Mekaru K, Tanaka SE, Arai W, Ashikawa K, Sakuraba Y, Nakamura R, Oishi S, Akamine K, Aoki Y

JBRA assisted reproduction ( Jornal Brasileiro de Reproducao Assistida )  27 ( 2 ) 267 - 281   2022年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVE: The role of Lactobacillus-dominant microbiota in the endometrium in reproductive function is unclear. We therefore aimed to explore the impact of the balance of Lactobacillus and pathological bacteria in the endometrial and vaginal microbiomes on the pregnancy outcomes of women treated with assisted reproductive technology (ART). METHODS: This study included 35 women with infertility submitted to good-quality embryo transfers. The cutoff values for abundance of Lactobacillus species (spp.) and pathological bacteria in the endometrium and vagina were calculated. Women with Lactobacillus spp. and pathological bacteria abundance above the cutoff values were categorized in the high-abundance group, whereas those with abundance below cutoff values were categorized in the low abundance group. We divided the patients into four groups based on the combination of high/low abundance of Lactobacillus spp. and pathological bacteria. RESULTS: The 35 cases of good-quality embryo transfer resulted in 21 pregnancies. Pregnant women were present in significantly higher proportions in the high Lactobacillus spp. abundance and low pathological bacteria abundance group, whereas the opposite combination (i.e., low Lactobacillus spp. abundance and high pathological bacteria abundance) saw a significantly higher proportion of nonpregnant women (p=0.022). CONCLUSIONS: The balance between Lactobacillus and pathological bacterial abundance in the endometrial and vaginal microbiomes is associated with pregnancy from ART.

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Is Music therapy effective for pain and anxiety during vaginal delivery in primiparous women?

Hayase Nitta1, 2, Tadatsugu Kinjo1, 2, Yoshino Kinjyo1, 2, Nana Yara1, 2, Yukiko Chinen1, 2, Miyuki Nishi2, Izumi Higa2, Shinobu Orita2, Mirai Miura2, Sakie Miyaguni2, Itomi Kaneshima1, Kumiko Nishihira1, Hitoshi Masamoto2, Keiko Mekaru2, and Yoichi Aoki1

Ryukyu Medical journal     2022年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Low-set umbilicus in a pregnant woman with bladder pseudoexstrophy: A case report.

Taira Y, Yara N, Kinjo Y, Kinjo T, Mekaru K, Aoki Y

Case reports in women's health ( Case Reports in Women's Health )  36   e00467   2022年10月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Bladder pseudoexstrophy is a rare form of bladder exstrophy. Bladder exstrophy occurs in 1 in every 30,000 to 50,000 live births. Because bladder pseudoexstrophy is asymptomatic, it may be undiagnosed even in adulthood. A 31-year-old woman with uterus bicornis unicollis and a low-set umbilicus underwent emergency cesarean delivery during the 37th week of pregnancy for chorioamnionitis. Perioperatively, asymptomatic anatomical abnormalities were identified, which included separated rectus abdominis muscles and diastasis of the symphysis pubis. The urinary tract was normal. The patient was diagnosed with bladder pseudoexstrophy. A low-set umbilicus may be a potential marker for the diagnosis of bladder pseudoextrophy.

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特集 見て,聞いて,触って,身体所見から考える妊産褥婦の異常とその対応 顔面まで浮腫がある

金城 忠嗣, 銘苅 桂子, 青木 陽一

周産期医学 ( 東京医学社 )  52 ( 8 ) 1073 - 1076   2022年08月

掲載種別: 研究論文（学術雑誌）

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増刊号 最新の不妊診療がわかる!-生殖補助医療を中心とした新たな治療体系 第3章　生殖補助医療の調節卵巣刺激 内因性LHサージ抑制法 Long法・Short法

銘苅 桂子

臨床婦人科産科 ( 株式会社医学書院 )  76 ( 4 ) 160 - 162   2022年04月

掲載種別: 研究論文（学術雑誌）

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今月の臨床 妊娠初期の経過異常とその対処-流産・異所性妊娠・絨毛性疾患の診断と治療 異所性妊娠 異所性妊娠のMRI診断

伊良波 裕子, 銘苅 桂子

臨床婦人科産科 ( 株式会社医学書院 )  76 ( 2 ) 233 - 238   2022年03月

掲載種別: 研究論文（学術雑誌）

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妊娠中に先行化学療法を施行した子宮頸癌の一例 当科の過去の症例と比較して

友寄 江梨佳, 仲本 朋子, 金城 淑乃, 渡部 俊陽, 高江洲 朋子, 大木 悠司, 下地 裕子, 仲宗根 忠栄, 新垣 精久, 平良 祐介, 久高 亘, 金城 忠嗣, 銘苅 桂子, 青木 陽一

沖縄産科婦人科学会雑誌 ( 沖縄産科婦人科学会 )  44   69 - 75   2022年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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妊娠合併子宮頸癌IB2期症例に対し化学療法を施行し生児を得た症例を経験したので当科の過去の症例との比較を交え報告する。症例は31歳1妊0産、妊娠22週で診断的円錐切除術を施行し子宮頸癌IB2期(FIGO 2018)と診断した。妊娠25週よりパクリタキセル、カルボプラチン療法を開始し計3コース施行。母体の有害事象や胎児の異常を認めなかった。妊娠35週4日に帝王切開+広汎子宮全摘術を施行。術後補助化学療法を行い現在まで再発なく経過している。2006〜2020年に当科で治療した妊娠合併子宮頸癌16例中、IB2期以上で生児を得たのは2例のみで、いずれも妊娠後期で診断されていた。本症例では妊娠中に化学療法を行い癌に対する治療の遅延なく妊娠を継続することができた。妊娠中の子宮頸癌に対する化学療法は治療の選択肢となりうるが、症例ごとに慎重な検討が必要である。(著者抄録)