{"created":"2023-06-20T15:49:05.188848+00:00","id":3631,"links":{},"metadata":{"_buckets":{"deposit":"253b0079-53f7-40f0-8146-83c607776676"},"_deposit":{"created_by":4,"id":"3631","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3631"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003631","sets":["1:12:74"]},"author_link":["10624","10625","10626","10627","10628","10629","10630","10631","10632","10633","10634","10635","10636"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-10","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"36","bibliographicPageStart":"29","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":"急性妊娠脂肪肝 (Acute fatty liver of pregnancy: AFLP) は一般的に嘔吐や上腹部痛などの臨床症状を呈することが多いが、今回我々は自覚症状に先行する血液凝固検査異常が契機となって診断した臨床的AFLPの症例を経験した。症例は33歳、初産婦の南米人で、妊婦健診では特記すべき異常なく経過していたが、妊娠35週に前期破水および陣痛発来したため総合病院に入院した。血液検査で肝酵素上昇や著明な血液凝固障害およびアンチトロンビン活性の低下を認め、臨床的AFLPが疑われた。高次施設である当院に搬送され、血液凝固因子の補充を含めた集学的な分娩管理を行った。本症例により臨床症状からAFLPの発症を疑うことが困難な場合があることが示唆され、分娩時に非凝固性出血を認める場合にはAFLPの可能性を考慮する必要があると考えられた。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Acute fatty liver of pregnancy (AFLP) typically presents with clinical symptoms such as vomiting and epigastric pain. We report a case of AFLP with preceding severe coagulopathy, followed by clinical symptoms. The patient, a 33-year-old South American woman, gravida 1 para 0, with no past history was admitted to the general hospital for labor onset with premature rupture of the membranes at 35 weeks of gestation. As blood screening tests revealed abnormally high liver enzymes and severe coagulopathy with markedly decreased antithrombin activity, AFLP was clinically suspected. She was transferred to our hospital where she had a successful vaginal delivery with intensive management in the operating room. As most patients with AFLP have chief complaints of digestive symptoms, physicians may have difficulty in diagnosing AFLP cases in which coagulopathy develops before clinical symptoms. Therefore, the differential diagnosis of AFLP may be necessary when the patient exhibits prolonged uncoagulable hemorrhage during delivery.","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":"平林, 慧","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"磯村, 直美","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小田, 智昭","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"成味, 恵","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松本, 雅子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"幸村, 友季子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"田村, 直顕","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"内田, 季之","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"鈴木, 一有","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊東, 宏晃","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金山, 尚裕","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"北村, 公也","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"成瀬, 香織","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":"2020-10-14"}],"displaytype":"detail","filename":"jsog_9_2_29.pdf","filesize":[{"value":"759.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_9_2_29","url":"https://hama-med.repo.nii.ac.jp/record/3631/files/jsog_9_2_29.pdf"},"version_id":"8f25644e-bb28-410e-9209-0b703116a621"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"acute fatty liver of pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"disseminated intravascular coagulation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"liver failure","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"coagulopathy","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":"自覚症状に先行する血液凝固検査異常が契機となって診断された臨床的急性妊娠脂肪肝の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"自覚症状に先行する血液凝固検査異常が契機となって診断された臨床的急性妊娠脂肪肝の一例","subitem_title_language":"ja"},{"subitem_title":"A case of acute fatty liver of pregnancy with preceding severe coagulopathy followed by clinical symptoms","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["74"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2020-10-14"},"publish_date":"2020-10-14","publish_status":"0","recid":"3631","relation_version_is_last":true,"title":["自覚症状に先行する血液凝固検査異常が契機となって診断された臨床的急性妊娠脂肪肝の一例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T06:58:31.816198+00:00"}