{"created":"2023-06-20T15:49:01.742778+00:00","id":3554,"links":{},"metadata":{"_buckets":{"deposit":"4d5ce528-10dd-4dba-9ec0-ea83a638c3c6"},"_deposit":{"created_by":4,"id":"3554","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3554"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003554","sets":["1:12:73"]},"author_link":["10413","10414","10415","10416","10417","10418","10419"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"29","bibliographicPageStart":"22","bibliographicVolumeNumber":"9","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"当院では、平成26年5月より緊急帝王切開のグレード分類運用を開始した。今回、緊急帝王切開を行った症例を対象に検討し、地方における地域周産期救急医療体制の問題点などについて考察した。5年間に当院で施行したグレードA緊急帝王切開は33件、児の出生週数は38週1日(中央値)、Apgar score5分値7.5点、臍帯動脈血ガスpH7.258 (平均値)であった。手術決定から児娩出までの時間(Decision to delivery interval：DDI)は31分(中央値)であり、平日日中は23分、休日は51.5分であった。常位胎盤早期剥離症例では、グレード分類運用開始後にDDIは短縮したが児の転帰は変わらなかった。DDIの内訳では入室または麻酔開始までに時間を要しており、都市部や大学病院のように宿直スタッフを常駐できない地方病院では人的不足が娩出時間遅延の最大要因となっていることが判明した。人的要因確保と共に、それを補うための設備・物品整備やシミュレーションなどの実施が望まれる。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"In our hospital, the grading of emergency Cesarean section was introduced in May 2014. In this study, we investigated patients who had undergone emergency Cesarean section, and reviewed the issues of emergency regional perinatal care systems in non-urban areas. In our hospital, grade A emergency Cesarean section was performed in 33 pregnant women during a period of 5 years. The median gestational age was 38 weeks and 1 day. The Apgar score at 5 minutes was 7.5. The mean umbilical cord arterial blood gas pH was 7.258. The median decision to delivery interval (DDI) was 31 minutes. It was 23 minutes in the daytime on weekdays and 51.5 minutes on holidays. In patients with premature abruption of the normally implanted placenta, the DDI was shortened after the introduction of grading, but there was no change in the neonatal outcome. Concerning the details of the DDI, a specific interval was required until admission to an operating room or the start of anesthesia, suggesting that an insufficient number of staff is the most important factor for a delay in the delivery time in regional hospitals whose night-duty staff may not stay in the hospital, differing from the status in urban areas or university hospitals. A sufficient number of staff should be secured, and equipment/commodity arrangement to compensate for any shortage or simulation activities should be conducted.","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_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"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_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"鈴木, 美沙子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊賀崎, 麻里","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"中野, 史織","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"深田, せり乃","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"東堂, 祐介","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"勝又, 佳菜","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"徳永, 直樹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-03-24"}],"displaytype":"detail","filename":"jsog_9_1_22.pdf","filesize":[{"value":"942.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_9_1_22","url":"https://hama-med.repo.nii.ac.jp/record/3554/files/jsog_9_1_22.pdf"},"version_id":"367c5bca-156f-40ab-969e-7ed75f952839"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"extremely emergency Cesarean section","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"grade A","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"regional perinatal care center","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"placental abruption","subitem_subject_language":"en","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":"当院における超緊急帝王切開術の現状と課題","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"当院における超緊急帝王切開術の現状と課題","subitem_title_language":"ja"},{"subitem_title":"Current status and issues of extremely emergency Cesarean section in our hospital","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["73"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2020-03-24"},"publish_date":"2020-03-24","publish_status":"0","recid":"3554","relation_version_is_last":true,"title":["当院における超緊急帝王切開術の現状と課題"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:57:39.182080+00:00"}