{"created":"2025-03-27T05:05:02.254807+00:00","id":2000378,"links":{},"metadata":{"_buckets":{"deposit":"794788a3-73f6-4466-a1be-64ef844093d8"},"_deposit":{"created_by":4,"id":"2000378","owner":"4","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"2000378"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:02000378","sets":["1:12:1742862347019"]},"author_link":[],"control_number":"2000378","item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2025-03-28","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"32","bibliographicPageStart":"24","bibliographicVolumeNumber":"13","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Journal of the Shizuoka Society of Obstetrics and Gynecology","bibliographic_titleLang":"en"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"子宮頸管妊娠に対するメソトレキセート（methotrexate：MTX）局所投与法の有益性を示す報告が近年増えている。ただし、MTX投与後に血清ヒト絨毛性ゴナドトロピン（human chorionic gonadotropin：hCG）値上昇を示す症例も多く、一過性の上昇なのか治療不十分でMTXの再投与を要するのか判断に苦慮することが少なくない。MTXの再投与基準としては1991年にStovallらが示した投与4日目と比較して7日目に上昇を認める場合再投与を行うとするものがあるが、これは卵管妊娠に対する全身投与における検討であり、子宮頸管妊娠は卵管妊娠と病態が異なるため7日目での再投与は必須ではない可能性が示唆されている。今回、2013年1月から2022年12月に当院でMTXの局所投与を行った子宮頸管妊娠7症例を後方視的に検討したところ、投与4日目から7日目に血清hCG値上昇を認めた3例を含め全7症例で10日目には血清hCG値が減少に転じていたことが確認された。子宮頸管妊娠は卵管妊娠に比べてMTX投与後のhCG値の低下が遅れる可能性があり、早期破裂のリスクも卵管妊娠よりは低いと考えられるため、投与7日目ではなく10日目までは再投与を延期して安全に管理できる可能性が高いと考えられた。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"A growing number of reports have shown the benefit of local methotrexate (MTX) therapy for cervical pregnancy. However, many patients experience an increase in human chorionic gonadotropin (hCG) levels after MTX administration, making it difficult to determine whether the increase is transient or if additional MTX treatment is required because of insufficient treatment. Regarding the criteria for MTX readministration, Stovall et al. reported in 1991 that MTX should be readministered when an increase in hCG levels is observed on Day 7 compared with Day 4 after systemic administration for tubal pregnancy. However, since the pathological condition of cervical pregnancy differs from that of tubal pregnancy, it has been suggested that cervical pregnancy may be safely monitored for several days without immediate readministration. We retrospectively investigated seven women with cervical pregnancy who received local MTX therapy at our hospital between January 2013 and December 2022. Serum hCG levels began to decrease on Day 10 in all seven cases, including three cases where hCG levels had risen between Day 4 and Day 7. The decrease in serum hCG levels after MTX administration may be delayed in cervical pregnancy compared with tubal pregnancy, and the risk of early rupture differs between these conditions. We conclude that cervical pregnancy may be safely managed without MTX readministration until Day 10 instead of Day 7.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_20":{"attribute_name":"EISSN","attribute_value_mlt":[{"subitem_source_identifier":"2187-1914","subitem_source_identifier_type":"EISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"0000000417639927","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"https://isni.org/isni/0000000417639927"},{"affiliationNameIdentifier":"0457h8c53","affiliationNameIdentifierScheme":"ROR","affiliationNameIdentifierURI":"https://ror.org/0457h8c53"}],"affiliationNames":[{"affiliationName":"静岡県立総合病院","affiliationNameLang":"ja"},{"affiliationName":"シズオカケンリツソウゴウビョウイン","affiliationNameLang":"ja-Kana"},{"affiliationName":"Shizuoka Prefectural Hospital Organization","affiliationNameLang":"en"}]}],"creatorNames":[{"creatorName":"吉田, 貴光","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"ヨシダ, タカアキ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Yoshida, Takaaki","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"谷, 洋彦","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"タニ, ヒロヒコ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Tani, Hirohiko","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"喜多, 眞梨子","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"キタ, マリコ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Kita, Mariko","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"坂本, 敬哉","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"サカモト, タカヤ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Sakamoto, Takaya","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"村越, まどか","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"ムラコシ, マドカ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Murakoshi, Madoka","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"上林, 翔大","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"カンバヤシ, ショウタ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Kanbayashi, Shota","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"小山, 瑠梨子","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"オヤマ, ルリコ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Oyama, Ruriko","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"浮田, 真沙世","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"ウキタ, マサヨ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Ukita, Masayo","creatorNameLang":"en","creatorNameType":"Personal"}]},{"creatorNames":[{"creatorName":"小阪, 謙三","creatorNameLang":"ja","creatorNameType":"Personal"},{"creatorName":"コサカ, ケンゾウ","creatorNameLang":"ja-Kana","creatorNameType":"Personal"},{"creatorName":"Kosaka, Kenzo","creatorNameLang":"en","creatorNameType":"Personal"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2025-03-31"}],"displaytype":"detail","filename":"jsog_13_1_24.pdf","filesize":[{"value":"849 KB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://hama-med.repo.nii.ac.jp/record/2000378/files/jsog_13_1_24.pdf"},"version_id":"7585e74c-512f-4f77-a4cb-a2db03820441"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"ectopic pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"異所性妊娠","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"cervical pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"子宮頸管妊娠","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"methotrexate","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"メソトレキセート","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"local injection","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"局所投与","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"human chorionic gonadotropin : hCG","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"ヒト絨毛性ゴナドトロピン","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"子宮頸管妊娠に対するMTX局所投与後の血清hCG値推移と再投与基準の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"子宮頸管妊娠に対するMTX局所投与後の血清hCG値推移と再投与基準の検討","subitem_title_language":"ja"}]},"item_type_id":"3","owner":"4","path":["1742862347019"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2025-03-28"},"publish_date":"2025-03-28","publish_status":"0","recid":"2000378","relation_version_is_last":true,"title":["子宮頸管妊娠に対するMTX局所投与後の血清hCG値推移と再投与基準の検討"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2025-03-28T01:11:52.003699+00:00"}