{"created":"2023-06-20T15:49:22.635600+00:00","id":3966,"links":{},"metadata":{"_buckets":{"deposit":"f4b104f4-4f09-4777-8627-5d263e19883a"},"_deposit":{"created_by":4,"id":"3966","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3966"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003966","sets":["1:12:80"]},"author_link":["12119","12120","12121","12122","12123","12124","12125","12126","12127","12128","12129","12130","12131"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-03-18","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"32","bibliographicPageStart":"26","bibliographicVolumeNumber":"11","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":"Fontan手術の進歩により、Fontan術後妊娠は増加している。Fontan術後妊娠における高率な周産期合併症が報告されているが、症例数が少なく管理方針は確立していない。\n32歳、1妊0産。無脾症候群、単心室症に対し9歳時に両大静脈肺動脈吻合手術（Fontan、Total cavopulmonary connection : TCPC）を行った。31歳時に妊娠を許可され自然妊娠に至る。妊娠16週以降、絨毛膜下血腫を継続して認めた。妊娠19週に262g（-1.5 SD）の胎児発育不全（FGR）と診断し、妊娠24週に586g（-2.2 SD）とFGRが進行し入院管理とした。妊娠26週に前期破水となった。抗菌薬などの集学的アプローチにも関わらず、妊娠継続が困難となり妊娠29週1日に帝王切開術を施行し、1157gの男児を出産した。\nFontan術後妊娠はFGRを始めとする様々な産科合併症が併発することが考えられ集学的な対応が必要となる。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Advances in Fontan operation have improved patient outcomes and led to an increasing number of pregnancies in women with Fontan circulation. Although a high occurring rate of perinatal complications has been reported in pregnancies among women with Fontan circulation, management strategies have not been established owing to the paucity of research.\nWe report the case of 32-year-old primigravida who had undergone the Fontan operation with an extracardiac total cavopulmonary connection (TCPC) at the age of 9 years for asplenia (right isomerism) and single ventricle. At the age of 31, she conceived naturally. Subchorionic hematoma was observed continuously from 16 weeks of gestation. She was diagnosed with fetal growth restriction (FGR) with 262g (-1.5 SD) weight of fetus at 19 weeks of gestation. At 24 weeks of gestation, the estimated fetal weight was 586g (-2.2 SD). She was admitted to the hospital for close observation of fetus and maternal bed rest. At 26 weeks of gestation preterm premature rupture of membranes (PPROM) was occurred. Despite multidisciplinary approach, it became difficult to administration of antimicrobial agents was challenging owing to hypersensitivity reactions. A cesarean section was performed at 29+1 weeks of gestation and she gave birth to a boy weighing 1157g. She was discharged from the hospital on the 12th postoperative day without any complications.\nOwing to the special circulatory dynamics in patients with Fontan circulation, placental circulation is suspected to be impaired. This leads to various obstetrical complications including FGR and subchorionic hematoma.\nMultidisciplinary approach is necessary in pregnancies with Fontan circulation.","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":"兪, 沙英","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"谷, 洋彦","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"宮﨑, 文","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金井, 亜未","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊田, 昴平","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"佐伯, 綾香","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"牧尾, 悟","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"吉田, 旭輝","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"梅宮, 槙樹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"辻, 満","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"敖, 礼","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"堀川, 直城","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小阪, 謙三","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":"2022-03-23"}],"displaytype":"detail","filename":"jsog_11_1_26.pdf","filesize":[{"value":"622.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_11_1_26","url":"https://hama-med.repo.nii.ac.jp/record/3966/files/jsog_11_1_26.pdf"},"version_id":"fc4b864a-c8c2-4ca8-9e82-39e639df04df"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Fontan circulation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"high-risk pregnancy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"fetal growth restriction","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"subchorionic hemorrhage","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"massive subchorionic hematoma","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":"子宮内胎児発育不全 (FGR) と巨大絨毛膜下血腫を合併したFontan術後妊娠の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"子宮内胎児発育不全 (FGR) と巨大絨毛膜下血腫を合併したFontan術後妊娠の一例","subitem_title_language":"ja"},{"subitem_title":"Pregnancy with fetal growth restriction and massive subchorionic hematoma following Fontan operation: A case report","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["80"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-03-23"},"publish_date":"2022-03-23","publish_status":"0","recid":"3966","relation_version_is_last":true,"title":["子宮内胎児発育不全 (FGR) と巨大絨毛膜下血腫を合併したFontan術後妊娠の一例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T07:00:06.415150+00:00"}