Pub Date : 2019-03-30DOI: 10.14390/JSSHP.HRP2018-012
K. Kuroda
Couples with unexplained recurrent pregnancy loss (RPL) cannot achieve a live birth due to repeated sporadic abortions or undetected causes of RPL on routine examinations. Adverse intrauterine circumstances and endometrial decidualization are candidate risk factors for unexplained RPL. During peri-implantation and decidualization, endometrial stromal cells are transformed into decidual cells through acute inflammatory reactions, followed by an anti-inflammatory state, via reprogramming of the corticosteroid and retinoid signaling pathways. Inappropriate inflammation in mid-luteal endometrial stromal cells, such as chronic endometritis, is associated with aberrantly elevated uNK cell density, abnormal angiogenesis, and impaired endometrial decidualization, leading to repeated reproductive failure and complications of pregnancy such as hypertensive disorders. To the best of our knowledge, no efficient treatment for unexplained RPL has yet been established. The optimization of intrauterine circumstances and endometrial decidualization may be key to treating unexplained RPL.
{"title":"Impaired endometrial function and unexplained recurrent pregnancy loss","authors":"K. Kuroda","doi":"10.14390/JSSHP.HRP2018-012","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2018-012","url":null,"abstract":"Couples with unexplained recurrent pregnancy loss (RPL) cannot achieve a live birth due to repeated sporadic abortions or undetected causes of RPL on routine examinations. Adverse intrauterine circumstances and endometrial decidualization are candidate risk factors for unexplained RPL. During peri-implantation and decidualization, endometrial stromal cells are transformed into decidual cells through acute inflammatory reactions, followed by an anti-inflammatory state, via reprogramming of the corticosteroid and retinoid signaling pathways. Inappropriate inflammation in mid-luteal endometrial stromal cells, such as chronic endometritis, is associated with aberrantly elevated uNK cell density, abnormal angiogenesis, and impaired endometrial decidualization, leading to repeated reproductive failure and complications of pregnancy such as hypertensive disorders. To the best of our knowledge, no efficient treatment for unexplained RPL has yet been established. The optimization of intrauterine circumstances and endometrial decidualization may be key to treating unexplained RPL.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/JSSHP.HRP2018-012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44324018","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 : 2019-03-30DOI: 10.14390/JSSHP.HRP2019-001
E. Kondoh, Yoshitsugu Chigusa, Akihiko Ueda, Baku Nakakita, Haruta Mogami, M. Mandai
Postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide.1) Blood transfusion is required in 4 to 5 cases per 1,000 deliveries in high resource countries.2) Uterine atony is a leading cause of PPH, and the use of intrauterine balloon tamponade (IBT) is recommended as the first-line surgical intervention for intractable atonic PPH. However, IBT fails to control uterine bleeding in roughly one-fifth of cases.3) We previously reported that intractable atonic PPH is invariably due to a serious subtype of PPH, termed “PRACE” (Postpartum hemorrhage, Resistance to treatment, and Arterial Contrast Extravasation on dynamic computed tomography (dCT) scans).4) Here we report that color Doppler ultrasonography can be a useful tool for diagnosing upper type of PRACE.
{"title":"Video image: Ultrasound findings of a novel subtype of atonic postpartum hemorrhage: is it still a diagnosis of exclusion?","authors":"E. Kondoh, Yoshitsugu Chigusa, Akihiko Ueda, Baku Nakakita, Haruta Mogami, M. Mandai","doi":"10.14390/JSSHP.HRP2019-001","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2019-001","url":null,"abstract":"Postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide.1) Blood transfusion is required in 4 to 5 cases per 1,000 deliveries in high resource countries.2) Uterine atony is a leading cause of PPH, and the use of intrauterine balloon tamponade (IBT) is recommended as the first-line surgical intervention for intractable atonic PPH. However, IBT fails to control uterine bleeding in roughly one-fifth of cases.3) We previously reported that intractable atonic PPH is invariably due to a serious subtype of PPH, termed “PRACE” (Postpartum hemorrhage, Resistance to treatment, and Arterial Contrast Extravasation on dynamic computed tomography (dCT) scans).4) Here we report that color Doppler ultrasonography can be a useful tool for diagnosing upper type of PRACE.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48897261","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 : 2019-03-30DOI: 10.14390/JSSHP.HRP2019-002
Y. Kubota, Yoshie Shibata, Shunji Suzuki
We report a case of peripartum asymptomatic cerebral hemorrhage (hereafter “PEACH”) in the frontal lobe, which was not diagnosed until postpartum day 8. A 35-year-old woman underwent cesarean section at 40 weeks of gestation due to non-reassuring fetal status during labor and gave birth to a healthy female baby. Her general conditions during labor, cesarean delivery, and postpartum period were uneventful. However, she developed hypertension 8 days after delivery, had headache and vertigo, and could not maintain a sitting position. Computed tomography revealed an edematous lesion in the vicinity of a hemorrhagic lesion in the right frontal cortex. Diffusion-weighted magnetic resonance imaging confirmed these findings, suggesting that several days or more had passed since the occurrence of asymptomatic cerebral hemorrhage. PEACH may occur in normotensive patients and cause nerve compression symptoms and hypertension over the course of a few days.
{"title":"Peripartum asymptomatic cerebral hemorrhage (PEACH)","authors":"Y. Kubota, Yoshie Shibata, Shunji Suzuki","doi":"10.14390/JSSHP.HRP2019-002","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2019-002","url":null,"abstract":"We report a case of peripartum asymptomatic cerebral hemorrhage (hereafter “PEACH”) in the frontal lobe, which was not diagnosed until postpartum day 8. A 35-year-old woman underwent cesarean section at 40 weeks of gestation due to non-reassuring fetal status during labor and gave birth to a healthy female baby. Her general conditions during labor, cesarean delivery, and postpartum period were uneventful. However, she developed hypertension 8 days after delivery, had headache and vertigo, and could not maintain a sitting position. Computed tomography revealed an edematous lesion in the vicinity of a hemorrhagic lesion in the right frontal cortex. Diffusion-weighted magnetic resonance imaging confirmed these findings, suggesting that several days or more had passed since the occurrence of asymptomatic cerebral hemorrhage. PEACH may occur in normotensive patients and cause nerve compression symptoms and hypertension over the course of a few days.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2019-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45438052","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 2018 Basic Research Establishment of advanced maternal age model mice: novel biomarker profiles in advanced maternal age with hypertensive disorders of pregnancy","authors":"K. Furuya, K. Kumasawa, H. Nakamura, T. Kimura","doi":"10.14390/JSSHP.6.39","DOIUrl":"https://doi.org/10.14390/JSSHP.6.39","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41948160","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":"The 7th Committee Meeting of Pregnancy Associated Stroke Proceedings","authors":"","doi":"10.14390/jsshp.6.41","DOIUrl":"https://doi.org/10.14390/jsshp.6.41","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48680088","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 : 2018-11-30DOI: 10.14390/JSSHP.HRP2018-009
Hironori Takahashi, Y. Baba, R. Usui, A. Ohkuchi, S. Matsubara
Various intrauterine hemostatic balloons for postpartum hemorrhage (PPH) have been developed. Among them, the Bakri balloon has been widely used for PPH after vaginal delivery and cesarean section (CS).1) This balloon is considered “easy to handle” and serves as a preventive treatment for PPH as “insurance,” which explains why its use has spread. While attempting to use it in many patients, we noted that the Bakri balloon is sometimes not so easy to handle. The obstacles hindering a smooth procedure, and thus effective hemostasis, are 1) the occasional difficulties in achieving smooth insertion of the balloon, and 2) the difficulties in keeping the balloon intrauterine, such that the balloon sometimes prolapses into the vagina. We developed several methods to overcome these problems,2–6) of which “holding the uterine cervix” (Matsubara-Takahashi [MT] holding)3) has already been explained in a video article2) of this journal. Here, we introduce two other useful procedures: the Nelaton (Matsubara)4) and Fishing (Matsubara) methods,5) both of which will enable obstetricians to handle easily the Bakri balloon during CS.
{"title":"Video image: Matsubara’s Nelaton and Fishing methods for easier Bakri balloon insertion and avoiding its prolapse during cesarean section","authors":"Hironori Takahashi, Y. Baba, R. Usui, A. Ohkuchi, S. Matsubara","doi":"10.14390/JSSHP.HRP2018-009","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2018-009","url":null,"abstract":"Various intrauterine hemostatic balloons for postpartum hemorrhage (PPH) have been developed. Among them, the Bakri balloon has been widely used for PPH after vaginal delivery and cesarean section (CS).1) This balloon is considered “easy to handle” and serves as a preventive treatment for PPH as “insurance,” which explains why its use has spread. While attempting to use it in many patients, we noted that the Bakri balloon is sometimes not so easy to handle. The obstacles hindering a smooth procedure, and thus effective hemostasis, are 1) the occasional difficulties in achieving smooth insertion of the balloon, and 2) the difficulties in keeping the balloon intrauterine, such that the balloon sometimes prolapses into the vagina. We developed several methods to overcome these problems,2–6) of which “holding the uterine cervix” (Matsubara-Takahashi [MT] holding)3) has already been explained in a video article2) of this journal. Here, we introduce two other useful procedures: the Nelaton (Matsubara)4) and Fishing (Matsubara) methods,5) both of which will enable obstetricians to handle easily the Bakri balloon during CS.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44232633","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":"Report on The 39th Annual Congress of the Japan Society for the Study of Hypertension in Pregnancy (JSSHP 2018)","authors":"","doi":"10.14390/jsshp.6.43","DOIUrl":"https://doi.org/10.14390/jsshp.6.43","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46237320","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}
Akihiko Ueda, Baku Nakakita, Yoshitsugu Chigusa, Hirohiko Tani, Haruta Mogami, M. Mandai, E. Kondoh
{"title":"Committee for Academic Affairs JSSHP Research Award 2018 Clinical Research Introducing tight systolic blood pressure control before 16 weeks’ gestation is associated with good pregnancy outcomes in patients with chronic hypertension","authors":"Akihiko Ueda, Baku Nakakita, Yoshitsugu Chigusa, Hirohiko Tani, Haruta Mogami, M. Mandai, E. Kondoh","doi":"10.14390/JSSHP.6.38","DOIUrl":"https://doi.org/10.14390/JSSHP.6.38","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46111840","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":"Development of methods for prevention and treatment of hypertension disorder of pregnancy","authors":"T. Ikeda","doi":"10.14390/JSSHP.6.40","DOIUrl":"https://doi.org/10.14390/JSSHP.6.40","url":null,"abstract":"","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48995358","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 : 2018-11-30DOI: 10.14390/JSSHP.HRP2018-008
Y. Ohashi, S. Farzi, N. Siddiqui
Neuraxial anesthesia is a gold standard anesthetic technique employed for labor analgesia and cesarean section. Spinal cord injury can occur if the needle insertion is performed above the recommended lumbar spine level. Pre-procedural lumbar spine ultrasound scanning can provide several benefits, such as increasing first attempt success rate, reducing the number of attempts, and reducing redirection of the needle. Pulmonary aspiration during general anesthesia is a fatal complication which remains a cause of maternal mortality. Gastric content volume (GCV) is an important component related to the risk of regurgitation followed by aspiration. There is growing interest in the utility of bedside gastric ultrasound to assess GCV in non-obstetric and obstetric populations.
{"title":"The use of lumbar spine and gastric ultrasound in perioperative obstetric anesthesia","authors":"Y. Ohashi, S. Farzi, N. Siddiqui","doi":"10.14390/JSSHP.HRP2018-008","DOIUrl":"https://doi.org/10.14390/JSSHP.HRP2018-008","url":null,"abstract":"Neuraxial anesthesia is a gold standard anesthetic technique employed for labor analgesia and cesarean section. Spinal cord injury can occur if the needle insertion is performed above the recommended lumbar spine level. Pre-procedural lumbar spine ultrasound scanning can provide several benefits, such as increasing first attempt success rate, reducing the number of attempts, and reducing redirection of the needle. Pulmonary aspiration during general anesthesia is a fatal complication which remains a cause of maternal mortality. Gastric content volume (GCV) is an important component related to the risk of regurgitation followed by aspiration. There is growing interest in the utility of bedside gastric ultrasound to assess GCV in non-obstetric and obstetric populations.","PeriodicalId":42505,"journal":{"name":"Hypertension Research in Pregnancy","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2018-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14390/JSSHP.HRP2018-008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45992594","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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