{"title":"Journal Awards for the Year 2019","authors":"","doi":"10.14390/jsshp.8.31","DOIUrl":"https://doi.org/10.14390/jsshp.8.31","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43309396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2020-003
Toru Kobayashi, Toshitaka Tanaka, M. Kawata, K. Oguma, Saki Ito, N. Matsuzawa, Y. Murase, Shotaro Yata, Satomi Tanaka, H. Kaneda
Aim: This study aimed to evaluate the effectiveness of intrauterine gauze or balloon tamponade for the management of postpartum hemorrhage due to uterine atony during maternal transportation from private clinics to higher-level facilities. Methods: A total of 1,428 patients were transported to the Department of Obstetrics, Juntendo University Shizuoka Hospital, between January 2008 and December 2019. Among these, 42 patients had postpartum hemorrhage due to uterine atony. Of the 42 patients, 29 (69.0%) were treated with intrauterine gauze or balloon tamponade before transportation (tamponade group); no intrauterine packing was performed in the remaining 13 (31.0%) (non-tamponade group). The primary outcome was the rate of critical obstetrical hemorrhage at hospital arrival. Secondary outcomes were blood loss before and after transportation, hemoglobin, platelets, fibrinogen, amount of blood transfusion, and rate of transfusion. Results: The rate of critical obstetrical hemorrhage was significantly lower in the tamponade group (34.5% (10/29)) compared to the non-tamponade group (76.9% (10/13)). Moreover, total blood loss during transportation and after hospital arrival was significantly lower in the tamponade group (487 ± 331 g) compared to the non-tamponade group (1,199 ± 1,012 g).
{"title":"Intrauterine gauze or balloon tamponade for the management of postpartum hemorrhage due to uterine atony during maternal transportation","authors":"Toru Kobayashi, Toshitaka Tanaka, M. Kawata, K. Oguma, Saki Ito, N. Matsuzawa, Y. Murase, Shotaro Yata, Satomi Tanaka, H. Kaneda","doi":"10.14390/jsshp.hrp2020-003","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-003","url":null,"abstract":"Aim: This study aimed to evaluate the effectiveness of intrauterine gauze or balloon tamponade for the management of postpartum hemorrhage due to uterine atony during maternal transportation from private clinics to higher-level facilities. Methods: A total of 1,428 patients were transported to the Department of Obstetrics, Juntendo University Shizuoka Hospital, between January 2008 and December 2019. Among these, 42 patients had postpartum hemorrhage due to uterine atony. Of the 42 patients, 29 (69.0%) were treated with intrauterine gauze or balloon tamponade before transportation (tamponade group); no intrauterine packing was performed in the remaining 13 (31.0%) (non-tamponade group). The primary outcome was the rate of critical obstetrical hemorrhage at hospital arrival. Secondary outcomes were blood loss before and after transportation, hemoglobin, platelets, fibrinogen, amount of blood transfusion, and rate of transfusion. Results: The rate of critical obstetrical hemorrhage was significantly lower in the tamponade group (34.5% (10/29)) compared to the non-tamponade group (76.9% (10/13)). Moreover, total blood loss during transportation and after hospital arrival was significantly lower in the tamponade group (487 ± 331 g) compared to the non-tamponade group (1,199 ± 1,012 g).","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44017501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Committee for Academic Affairs JSSHP Research Award 2020 Clinical Research and Basic Research","authors":"","doi":"10.14390/jsshp.8.33","DOIUrl":"https://doi.org/10.14390/jsshp.8.33","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43587525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2019-013
Takashi Kobayashi, S. Ueda, M. Takagi, M. Kihara, Yusuke Suzuki
Hypertensive disorders of pregnancy (HDP) represent a major cause of maternal and neonatal morbidity and mortality. Studies conducted over the last decade have improved our understanding of the potential mechanisms underlying HDP pathogenesis. The first step in HDP is reduced uteroplacental perfusion as a result of abnormal extravillous trophoblast invasion of spiral arterioles. Subsequent placental ischemia leads to maternal vascular endothelial dysfunction that may be caused by an imbalance between pro- and anti-angiogenic factors, enhanced formation of vasocontractile factors such as endothelin and thromboxane, increased vascular sensitivity to angiotensin II, and/or decreased formation of vasodilators such as nitric oxide (NO) and prostaglandin I2. NO is one of the major mediators from the endothelium, and its production is modified by endogenous NO synthase inhibitors such as asymmetric dimethylarginine (ADMA). ADMA levels are generally higher in patients with cardiovascular and metabolic diseases and widely recognized as a prognostic marker for major cardiovascular events and mortality. Recent studies have found ADMA levels to be higher in patients with preeclampsia. In addition, multiple studies indicate that elevated ADMA in early stages of pregnancy might predict the development of preeclampsia. Finally, ADMA has been found to be associated with uterine artery flow disturbance. Collectively, these findings strongly suggest that elevated ADMA-mediated endothelial dysfunction could be a causative factor for HDP. In this review, we discuss the biology of ADMA, with a particular focus on its potential role in HDP.
{"title":"Pathophysiological roles of ADMA-mediated endothelial injury in hypertensive disorders of pregnancy","authors":"Takashi Kobayashi, S. Ueda, M. Takagi, M. Kihara, Yusuke Suzuki","doi":"10.14390/jsshp.hrp2019-013","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2019-013","url":null,"abstract":"Hypertensive disorders of pregnancy (HDP) represent a major cause of maternal and neonatal morbidity and mortality. Studies conducted over the last decade have improved our understanding of the potential mechanisms underlying HDP pathogenesis. The first step in HDP is reduced uteroplacental perfusion as a result of abnormal extravillous trophoblast invasion of spiral arterioles. Subsequent placental ischemia leads to maternal vascular endothelial dysfunction that may be caused by an imbalance between pro- and anti-angiogenic factors, enhanced formation of vasocontractile factors such as endothelin and thromboxane, increased vascular sensitivity to angiotensin II, and/or decreased formation of vasodilators such as nitric oxide (NO) and prostaglandin I2. NO is one of the major mediators from the endothelium, and its production is modified by endogenous NO synthase inhibitors such as asymmetric dimethylarginine (ADMA). ADMA levels are generally higher in patients with cardiovascular and metabolic diseases and widely recognized as a prognostic marker for major cardiovascular events and mortality. Recent studies have found ADMA levels to be higher in patients with preeclampsia. In addition, multiple studies indicate that elevated ADMA in early stages of pregnancy might predict the development of preeclampsia. Finally, ADMA has been found to be associated with uterine artery flow disturbance. Collectively, these findings strongly suggest that elevated ADMA-mediated endothelial dysfunction could be a causative factor for HDP. In this review, we discuss the biology of ADMA, with a particular focus on its potential role in HDP.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48695518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2020-010
K. Papadakis, S. Myriknas, L. Kidd, Natasha Singh
Aim: External cephalic version (ECV) is the main intervention for facilitating vaginal birth without increasing intrapartum mortality and neonatal morbidity in term breech pregnancies. We appraise the hypothesis that the introduction of a specialised ECV clinic reduces preventable caesareans without compromising neonatal well-being. Methods: This is a prospective cohort study over a period of 3 years. Data were collected via attendance in the ECV clinic and women were followed up until the delivery and the postnatal period. Obstetric and neonatal notes were reviewed in order to assess obstetric data and fetal outcomes. Results: 181 suitable women with singleton pregnancy were included in our sample, from which 28 opted for elective caesarean delivery. 81% of the eligible women underwent an ECV. From the 120 ECVs performed, 78 women were nulliparous and 42 multiparous. The ECV was successful in a total of 64 cases (54%), 49% in nulliparous and 62% in multiparous women. Following that, 78% delivered vaginally of which 25% needed instrumental delivery. There were not any adverse events during the ECVs and no woman underwent emergency caesarean section for fetal distress due to the procedure. Conclusion: Our experience favours the ECV clinic, as it improves vaginal delivery rates with no obvious maternal and neonatal compromise. Cost-effectiveness and maternal satisfaction levels remain unknown. There is still room for improvement in detection, uptake and success ECV rates.
{"title":"Obstetric outcomes after instituting a dedicated External Cephalic Version clinic in a large tertiary centre: a 3-year prospective cohort study","authors":"K. Papadakis, S. Myriknas, L. Kidd, Natasha Singh","doi":"10.14390/jsshp.hrp2020-010","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-010","url":null,"abstract":"Aim: External cephalic version (ECV) is the main intervention for facilitating vaginal birth without increasing intrapartum mortality and neonatal morbidity in term breech pregnancies. We appraise the hypothesis that the introduction of a specialised ECV clinic reduces preventable caesareans without compromising neonatal well-being. Methods: This is a prospective cohort study over a period of 3 years. Data were collected via attendance in the ECV clinic and women were followed up until the delivery and the postnatal period. Obstetric and neonatal notes were reviewed in order to assess obstetric data and fetal outcomes. Results: 181 suitable women with singleton pregnancy were included in our sample, from which 28 opted for elective caesarean delivery. 81% of the eligible women underwent an ECV. From the 120 ECVs performed, 78 women were nulliparous and 42 multiparous. The ECV was successful in a total of 64 cases (54%), 49% in nulliparous and 62% in multiparous women. Following that, 78% delivered vaginally of which 25% needed instrumental delivery. There were not any adverse events during the ECVs and no woman underwent emergency caesarean section for fetal distress due to the procedure. Conclusion: Our experience favours the ECV clinic, as it improves vaginal delivery rates with no obvious maternal and neonatal compromise. Cost-effectiveness and maternal satisfaction levels remain unknown. There is still room for improvement in detection, uptake and success ECV rates.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44597837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2020-009
A. Ohkuchi, E. Kondoh, Tatsuo Yamamoto, H. Seki, S. Saito, S. Makino, Miwa Nishida, T. Kikuchi
ratio of tyrosine to placental growth factor (sFlt-1/PlGF ratio), a flow diagram for the short-term prediction of preeclampsia (PE) using the sFlt-1/PlGF ratio in women at imminent/basal risk of preeclampsia. sFlt-1/PlGF flow for PE using ratio in at risk of PE at of consensus of at Web Meeting” held on expert consensus, appropriate perinatal care under close observation is recommended for women at imminent/basal risk of PE who have an sFlt-1/PlGF ratio > 38 at recruitment. For women at imminent risk of PE who have an sFlt-1/PlGF ratio ≤ 38 at recruitment, shortening the interval between maternal check-ups is recommended, along with re-evaluation of the sFlt-1/PlGF ratio 1–4 weeks after initial blood sampling, based on patient/fetal condition. using the sFlt-1/PlGF ratio under insurance in at of and
{"title":"Expert consensus: Indication criteria and screening strategy for preeclampsia using the serum sFlt-1/PlGF ratio at 18–36 weeks of gestation in women at imminent/basal risk of preeclampsia under insurance coverage","authors":"A. Ohkuchi, E. Kondoh, Tatsuo Yamamoto, H. Seki, S. Saito, S. Makino, Miwa Nishida, T. Kikuchi","doi":"10.14390/jsshp.hrp2020-009","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-009","url":null,"abstract":"ratio of tyrosine to placental growth factor (sFlt-1/PlGF ratio), a flow diagram for the short-term prediction of preeclampsia (PE) using the sFlt-1/PlGF ratio in women at imminent/basal risk of preeclampsia. sFlt-1/PlGF flow for PE using ratio in at risk of PE at of consensus of at Web Meeting” held on expert consensus, appropriate perinatal care under close observation is recommended for women at imminent/basal risk of PE who have an sFlt-1/PlGF ratio > 38 at recruitment. For women at imminent risk of PE who have an sFlt-1/PlGF ratio ≤ 38 at recruitment, shortening the interval between maternal check-ups is recommended, along with re-evaluation of the sFlt-1/PlGF ratio 1–4 weeks after initial blood sampling, based on patient/fetal condition. using the sFlt-1/PlGF ratio under insurance in at of and","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49061075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Best Reviewer Awards","authors":"","doi":"10.14390/jsshp.8.32","DOIUrl":"https://doi.org/10.14390/jsshp.8.32","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41579833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2020-019
J. Takeda, M. Nakabayashi†
To the Editor: In recent years, Japan has faced a rapidly and continuously declining birth rate similar to or even worse than those of other developed countries. The global COVID-19 pandemic in 2020 has further exacerbated this. Our purpose for writing this letter is to raise awareness on the relationship between the COVID-19 pandemic and declining birth rate in Japan. The COVID-19 pandemic in Japan noticeably worsened at the end of March 2020, and with the government’s declaration of a state of emergency, people voluntarily refrained from going outside unless urgently needed until June. If women became pregnant during this period, their estimated due dates would be in the first three months of 2021. Thus, we investigated the number of delivery appointments for these three months. The number of births in 2019 was 865,239, which amounts to a 5.8% decrease compared to the year before.1) If this decreasing trend continues this year, then the number of delivery appointments at delivery facilities should decrease by about 5%. However, in reality, the decrease is even greater (Figure). The difference of approximately 10–25% is not the result of a spontaneous decrease in the number of births, but likely due to another factor. Part of this difference might be explained by the temporary postponing of assisted reproductive technology in view of the statement set forth by the Japan Society for Reproductive Medicine (April 1, 2020).2) However, the entire difference cannot be solely pinned on this. Hospitals which provided data for this study are tertiary hospitals, as well as perinatal medical centers that take on cases of maternal transport or fetal congenital anomalies, which might be included in delivery appointments. However, given the magnitude of the difference, we view the avoidance of becoming pregnant due to fears of COVID-19 to be a major contributing factor. We propose the following three measures. First, a national survey of birth appointments should be conducted. Second, trends of decreasing birth appointments should be closely and continuously monitored. Lastly, the public should be provided with accurate information regarding the relationship between maternal and neonatal COVID19 infection. For the first measure, the use of data limited to tertiary hospitals and urban areas paints the picture that the COVID-19 situation is worse compared to rural areas. Thus, data from rural areas and local clinics should also be examined to determine whether similar trends are observed. For the second measure, the postponement of assisted reproductive technology was temporary and has now returned to normal after another announcement from Ch an ge s o f b irt h ap po in tm en ts (% )
{"title":"Expected reduction in the number of births due to the COVID-19 pandemic and proposal for countermeasures","authors":"J. Takeda, M. Nakabayashi†","doi":"10.14390/jsshp.hrp2020-019","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-019","url":null,"abstract":"To the Editor: In recent years, Japan has faced a rapidly and continuously declining birth rate similar to or even worse than those of other developed countries. The global COVID-19 pandemic in 2020 has further exacerbated this. Our purpose for writing this letter is to raise awareness on the relationship between the COVID-19 pandemic and declining birth rate in Japan. The COVID-19 pandemic in Japan noticeably worsened at the end of March 2020, and with the government’s declaration of a state of emergency, people voluntarily refrained from going outside unless urgently needed until June. If women became pregnant during this period, their estimated due dates would be in the first three months of 2021. Thus, we investigated the number of delivery appointments for these three months. The number of births in 2019 was 865,239, which amounts to a 5.8% decrease compared to the year before.1) If this decreasing trend continues this year, then the number of delivery appointments at delivery facilities should decrease by about 5%. However, in reality, the decrease is even greater (Figure). The difference of approximately 10–25% is not the result of a spontaneous decrease in the number of births, but likely due to another factor. Part of this difference might be explained by the temporary postponing of assisted reproductive technology in view of the statement set forth by the Japan Society for Reproductive Medicine (April 1, 2020).2) However, the entire difference cannot be solely pinned on this. Hospitals which provided data for this study are tertiary hospitals, as well as perinatal medical centers that take on cases of maternal transport or fetal congenital anomalies, which might be included in delivery appointments. However, given the magnitude of the difference, we view the avoidance of becoming pregnant due to fears of COVID-19 to be a major contributing factor. We propose the following three measures. First, a national survey of birth appointments should be conducted. Second, trends of decreasing birth appointments should be closely and continuously monitored. Lastly, the public should be provided with accurate information regarding the relationship between maternal and neonatal COVID19 infection. For the first measure, the use of data limited to tertiary hospitals and urban areas paints the picture that the COVID-19 situation is worse compared to rural areas. Thus, data from rural areas and local clinics should also be examined to determine whether similar trends are observed. For the second measure, the postponement of assisted reproductive technology was temporary and has now returned to normal after another announcement from Ch an ge s o f b irt h ap po in tm en ts (% )","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42075602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.14390/jsshp.hrp2020-005
S. Takeda
Rapid progress in perinatal care in recent decades has led to a dramatic decline in perinatal, neonatal, and maternal mortality (excluding suicides), and achieved remarkable improvements in obstetrical outcomes in Japan. However, while maternal mortality had been on a continuous and steady decline up until 2007 (3.1/100,000 total births), the rate has been fluctuating since then (e.g., 2.7/100,000 in 2014, 3.4/100,000 in 2016). This is likely attributed to a variety of factors that have emerged in the past 20 years due to changes in the environment and social situation surrounding women, such as later marriage and rise in maternal age. In Western countries, “late maternal deaths” occurring between 42 days and one year after delivery are considered to be just as important as “maternal deaths,” i.e., deaths during pregnancy or within 42 days of termination of pregnancy. In particular, suicides attributable to psychiatric disorders have become a serious issue among women less than one year postpartum. However, in Japan, the actual number of deaths by suicide is unknown, since neither death certificates nor postmortem certificates include information on pregnancy and delivery. Despite the fact that the total number of suicide deaths in Japan is known, whether such deaths are associated with perinatal mental issues or not is unclear, and thus, no measures have been taken. Untreated perinatal depression and psychiatric disorders not only cause issues such as suicide, but are also related to pediatric developmental and mental disorders, neglect, and/or child abuse due to impaired nurturing ability. Suicide rates among pregnant and parturient women in Osaka, Tokyo, and Mie are much higher than those of the UK, the US, and Sweden. There is an urgent need to establish a regional support system that facilitates interactions among the obstetrical, pediatric, psychiatric field, and local administrations for monitoring and supporting mothers and infants, as well as a system that allows families, schools, and society to support young people, in order to realize improved preconception health care.
{"title":"The current status of and measures against maternal suicide in Japan","authors":"S. Takeda","doi":"10.14390/jsshp.hrp2020-005","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-005","url":null,"abstract":"Rapid progress in perinatal care in recent decades has led to a dramatic decline in perinatal, neonatal, and maternal mortality (excluding suicides), and achieved remarkable improvements in obstetrical outcomes in Japan. However, while maternal mortality had been on a continuous and steady decline up until 2007 (3.1/100,000 total births), the rate has been fluctuating since then (e.g., 2.7/100,000 in 2014, 3.4/100,000 in 2016). This is likely attributed to a variety of factors that have emerged in the past 20 years due to changes in the environment and social situation surrounding women, such as later marriage and rise in maternal age. In Western countries, “late maternal deaths” occurring between 42 days and one year after delivery are considered to be just as important as “maternal deaths,” i.e., deaths during pregnancy or within 42 days of termination of pregnancy. In particular, suicides attributable to psychiatric disorders have become a serious issue among women less than one year postpartum. However, in Japan, the actual number of deaths by suicide is unknown, since neither death certificates nor postmortem certificates include information on pregnancy and delivery. Despite the fact that the total number of suicide deaths in Japan is known, whether such deaths are associated with perinatal mental issues or not is unclear, and thus, no measures have been taken. Untreated perinatal depression and psychiatric disorders not only cause issues such as suicide, but are also related to pediatric developmental and mental disorders, neglect, and/or child abuse due to impaired nurturing ability. Suicide rates among pregnant and parturient women in Osaka, Tokyo, and Mie are much higher than those of the UK, the US, and Sweden. There is an urgent need to establish a regional support system that facilitates interactions among the obstetrical, pediatric, psychiatric field, and local administrations for monitoring and supporting mothers and infants, as well as a system that allows families, schools, and society to support young people, in order to realize improved preconception health care.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49540733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01DOI: 10.14390/jsshp.hrp2020-012
Tomomi Yamazaki, A. Cerdeira, S. Agrawal, I. Koh, J. Sugimoto, M. Vatish, Y. Kudo
Preeclampsia is a major complication of pregnancy and is associated with significant fetal and maternal morbidity and mortality. Timely prediction of preeclampsia facilitates referral of potential patients to an adequate tertiary center, which helps reduce adverse outcomes associated with the disease. Moreover, by accurately ruling out preeclampsia, patients can be discharged safely and relieved of anxiety. Numerous candidate biomarkers have been proposed for the diagnosis and prediction of preeclampsia. Among these, maternal circulating factors such as soluble FMS-like tyrosine kinase-1 (sFlt-1), an anti-angiogenic factor, and placental growth factor (PlGF), an angiogenic factor, are considered the most promising. Measuring these factors as a ratio allows assessment of the angiogenic imbalance that characterizes incipient or overt preeclampsia. The sFlt-1/PlGF ratio increases before the onset of preeclampsia and thus may help predict the disease. The test is used as a predictive tool in several countries but not yet routinely performed in Japanese hospitals. We performed a systematic review of studies that assessed the performance of the sFlt-1/PlGF ratio in predicting preeclampsia in Japanese patients. Three studies were included in the systematic review. All studies reported high negative predictive values of the sFlt-1/PlGF ratio (i.e., for ruling out PE), in agreement with the current evidence of the test performance worldwide. The sFlt-1/PlGF ratio could be of significant relevance in the Japanese population.
{"title":"Predictive Accuracy of Soluble FMS-Like Tyrosine Kinase-1/Placental Growth Factor Ratio for Preeclampsia in Japan: A Systematic Review","authors":"Tomomi Yamazaki, A. Cerdeira, S. Agrawal, I. Koh, J. Sugimoto, M. Vatish, Y. Kudo","doi":"10.14390/jsshp.hrp2020-012","DOIUrl":"https://doi.org/10.14390/jsshp.hrp2020-012","url":null,"abstract":"Preeclampsia is a major complication of pregnancy and is associated with significant fetal and maternal morbidity and mortality. Timely prediction of preeclampsia facilitates referral of potential patients to an adequate tertiary center, which helps reduce adverse outcomes associated with the disease. Moreover, by accurately ruling out preeclampsia, patients can be discharged safely and relieved of anxiety. Numerous candidate biomarkers have been proposed for the diagnosis and prediction of preeclampsia. Among these, maternal circulating factors such as soluble FMS-like tyrosine kinase-1 (sFlt-1), an anti-angiogenic factor, and placental growth factor (PlGF), an angiogenic factor, are considered the most promising. Measuring these factors as a ratio allows assessment of the angiogenic imbalance that characterizes incipient or overt preeclampsia. The sFlt-1/PlGF ratio increases before the onset of preeclampsia and thus may help predict the disease. The test is used as a predictive tool in several countries but not yet routinely performed in Japanese hospitals. We performed a systematic review of studies that assessed the performance of the sFlt-1/PlGF ratio in predicting preeclampsia in Japanese patients. Three studies were included in the systematic review. All studies reported high negative predictive values of the sFlt-1/PlGF ratio (i.e., for ruling out PE), in agreement with the current evidence of the test performance worldwide. The sFlt-1/PlGF ratio could be of significant relevance in the Japanese population.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43340211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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