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Different Fetal and Neonatal Growth between Early- and Late-Onset Preeclampsia

Open Journal of Obstetrics and Gynecology 2015年第9期5卷 516-521页

作者： Takashi Mitsui Hisashi Masuyama Eriko Eto Etsuko Nobumoto Kei Hayata yuji hiramatsu Department of Obstetrics and Gynecology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan

Preeclampsia is a heterogeneous disease, and there are major differences in severity, fetal growth and poor placentation between early- and late-onset preeclampsia. Here, we examined the effect of onset period on fetal and neonatal growth in preeclampsia with a cross-sectional study including 102 pregnant women with preeclampsia visited Okayama University Hospital from 2009 to 2013. The subjects were retrospectively compared in terms of body mass index (BMI), weight gain during pregnancy, complications, weeks of delivery, neonatal body weight and BMI at birth, fetal growth restriction (FGR), small for gestational age (SGA), pathological findings in the placenta, and infant’s weight at 1 month after birth. Neonatal body weight and BMI at birth were significantly lower and the extent of FGR and the frequency of SGA were higher in early-onset group compared with late-onset group. Mean daily weight gain during the neonatal period was significantly lower in the early-onset group compared with the late-onset group, however the weight gain rate during the neonatal period in the early-onset group was higher than that in late-onset group. In conclusions, there are significant differences in fetal and neonatal growth between early- and late-onset preeclampsia and the catch up for growth might start during neonatal period.

关键词： Body Mass Index Fetal Growth Restriction Onset Period Preeclampsia

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Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization

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Open Journal of Obstetrics and Gynecology 2013年第10期3卷 711-716页

作者： Hisashi Masuyama Seiji Inoue Etsuko Nobumoto Kei Hayata Tomonori Segawa yuji hiramatsu Department of Obstetrics and Gynecology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science Okayama Japan

The aim of this retrospective case series report is to evaluate systemic methotrexate therapy in conjunction with uterine artery embolization (UAE) in the conservative management of cervical pregnancy. We examined clinical presentations, treatments, and therapeutic outcomes in fifteen patients with a cervical pregnancy who wished for preservation of fertility, treated at Okayama University Hospital between 1998 and 2012. Twelve patients received systemic methotrexate including five treated with UAE. One was treated with UAE alone. Two patients received neither UAE nor methotrexate because of a low human chorionic gonadotropin (hCG) level and poor blood flow around the gestational sac (GS). An increased GS size and the elevated hCG level during methotrexate therapy might be risk factors for emergent UAE. Two of six patients treated with UAE had subsequent confirmed viable pregnancies. In patients with a cervical pregnancy, methotrexate therapy in combination with UAE can be considered as an option before performing a hysterectomy with suitable counseling about the risk of loss of fertility. Careful observation of the GS size and hCG level during methotrexate therapy might be important for management.

关键词： Cervical Pregnancy Methotrexate Uterine Artery Embolization Dilatation and Curettage Human Chorionic Gonadotropin

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