Masatoki Kaneko

Effect of the free radical scavenger, 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), on hypoxia-ischemia-induced brain injury in neonatal rats

The free radical scavenger 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), which has been approved in Japan for use in patients with cerebral infarction, was used to treat ischemic-hypoxic brain damage in neonatal rats. Seven-day-old rat pups were subjected to a modified Levine procedure, then given either vehicle or MCI-186 (at one of three dosage levels: 3, 6, or 9 mg/kg), and the extent of brain damage was evaluated either 24 h or 7 days later. The administration of MCI-186 significantly attenuated damage, in a dose-dependent manner. These results indicate that MCI-186 is a promising candidate for the treatment of neonatal hypoxic-ischemic encephalopathy.

Fetal manifestations and poor outcomes of congenital cytomegalovirus infections: Possible candidates for intrauterine antiviral treatments

Aim:  This retrospective study was performed to reveal the natural history of cytomegalovirus (CMV) infected fetuses during the perinatal period and to find prenatal findings associated with poor outcomes.

Perinatal death and neurological damage as a sequential chain of poor outcome

Objective: We investigated the risk factors of perinatal death and neurological damage. Methods: Perinatal death and neurological damage were retrospectively investigated using a population-based study of 108 024 deliveries from 1998 to 2007. Main factors studied were asphyxia, growth restriction and preterm delivery < 34 weeks of gestation, since these three factors were most often associated with poor prognosis. The impact of each factor was identified by multiple regression analyses. Results: There were 459 perinatal deaths (4.3/1000) and 220 neurological damages (2.0/1000). Preterm delivery accounted for 50% of perinatal deaths and neurological damage, whereas it constituted 2.6% of total births. Multiple regression analyses showed that prematurity < 34 weeks (10-fold), asphyxia (10-fold) and growth restriction (2-fold) were independent and significant risk factors associated with poor outcomes, and that the magnitude was similar throughout the three consecutive critical events of fetal death, neonatal death and neurological damage. Conclusions: Prematurity < 34 weeks, asphyxia and growth restriction are independent and persistent risk factors from perinatal death to neurological damage.

Clinical factors that enhance morbidity and mortality in intrauterine growth restricted foetuses delivered between 23 and 30 weeks of gestation

Objective. To find clinical factors that are associated with poor outcome (death and brain damage) in premature intrauterine growth restricted (IUGR) infants. Methods. A retrospective study was performed to compare the incidence of poor outcome between 45 IUGR and 203 appropriate-for-gestational-age (AGA) infants born before 30 weeks of gestation. Foetal tests included foetal heart rate monitoring, Doppler flow, amniotic fluid, and head circumference. Growth for gestational age was categorised as 10th through 3rd, third through first, and below first percentiles. Results. In infants below 25 weeks of gestation, the incidence of poor outcome was not different between IUGR and AGA. In infants between 25 and 30 weeks of gestation, the incidence of poor outcome was significantly increased in IUGR compared with AGA (12/40, 30% versus 11/136, 8.1%, p < 0.01). Univariate analysis showed that abnormality in foetal heart rate monitoring [odds ratio (OR) 8.3, 95% confidence interval (CI) 1.58–43.6], head circumference (OR 7.0, 95%CI 1.42–34.4), and Doppler flow (OR 10.9, 95%CI 1.83–64.6) was significantly associated with poor outcome in IUGR infants. However, no foetal tests were significantly associated with poor outcome after adjusting for the 3-grade birthweight percentiles. Conclusions. Immaturity outweighs clinical problem associated with IUGR in infants below 25 weeks of gestation. Between 25 and 30 weeks of gestation, there was a growth threshold below third percentile where foetal tests were not significant predictors of poor outcome, but that was primarily determined by birthweight.

Perinatal morbidity and mortality for extremely low‐birthweight infants: A population‐based study of regionalized maternal and neonatal transport

The aim of this study was to clarify the mortality and long‐term outcomes of extremely low‐birthweight infants according to the process of maternal or infant transport and indications for maternal transport.

Mortality rates for extremely low‐birthweight infants: A regional, population‐based study in Japan during 2005–2009

Aim:  We investigated neonatal and infant mortality rates for extremely low‐birthweight infants and clarified clinical factors associated with death.

Case report and review of delayed-interval delivery for dichorionic, diamniotic twins with normal development

We report a case of delayed‐interval delivery of a dichorionic, diamniotic twin pregnancy with the survival of both twins. The patient presented at 22 weeks and 1 day of gestation with vaginal bleeding and preterm labor. Five days later, the first twin was born. The second twin remained in utero. The management consisted of careful monitoring of both maternal and fetal status. Nine days later, the second twin was delivered vaginally. Both twins received full resuscitation and immediate life‐support intervention; at 7 years of age both twins exhibited normal development.

Rubella outbreak on Tokunoshima Island in 2004: serological and epidemiological analysis of pregnant women with rubella.

Aim:  This paper presents the serological and epidemiological background of the rubella‐infected pregnant women following the rubella outbreak throughout Tokunoshima Island that occurred after the revision of the immunization law in Japan.

Antepartum Evaluation of Monochorionic Diamniotic (MD) Twins; MD‐Twin Score: A New Scoring Method for Perinatal Outcome

Objective: Our purpose was to establish a new scoring method to survey monochorionic diamniotic (MD) twins during antepartum periods.

Rubella outbreak on Tokunoshima Island in 2004: A population-based study of pregnant women

Aim:  The purpose of this study was to clarify the risk of rubella infection for pregnant women in the outbreak area.