Biomedical subjects

Akio Izumi

Publications and source records attributed to Akio Izumi.

6 recordsLinked to original sources

PubMed2003

Woman with postpartum ventricular tachycardia and hypomagnesemia.

A 28-year-old Japanese woman who had received continuous intravenous infusion of magnesium sulfate from 24 weeks of pregnancy until delivery underwent cesarean section at 30 weeks and gave birth to twins. Serum magnesium sharply declined to a subnormal level of 1.5 mg/dL on postpartum day 4. The patient exhibited sinus bradycardia (48 b.p.m.) with intermittent supraventricular contraction on postpartum day 2, intermittent ventricular bigeminy on postpartum day 3, and frequent selfterminated polymorphic ventricular tachycardia on postpartum day 4. The electrocardiogram (ECG) disclosed that the patient had prolonged QTc of 0.45-0.67. Correction of serum magnesium improved ECG findings promptly, resulting in the disappearance of arrhythmias. Hypomagnesemia due to postpartum diuresis may have played a role causing ventricular tachyarrhythmia in this patient.

Adult↗

PubMed2003

Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases.

OBJECTIVE: An extensive study as to whether maternal age itself is a risk factor for blood loss during parturition. METHOD: A total of 10,053 consecutive women who delivered a singleton infant were studied. The excess blood loss was defined separately for women with vaginal and cesarean deliveries as > or = 90th centile value for each delivery mode. The effects of 13 potential risk factors on blood loss were analyzed using multivariate analysis. RESULTS: The 90th centile value of blood loss was 615 ml and 1,531 ml for women with vaginal and cesarean deliveries, respectively. A low lying placenta (odds ratio [OR], 4.4), previous cesarean (3.1), operative delivery (2.6), leiomyoma (1.9), primiparity (1.6), and maternal age > or = 35 years (1.5) were significant independent risk factors for excess blood loss in women with vaginal delivery. Placenta previa (6.3), leiomyoma (3.6), low lying placenta (3.3), and maternal age > or = 35 years (1.8) were significant independent risk factors for excess blood loss in women with cesarean sections. CONCLUSION: A maternal age of > or = 35 years was an independent risk factor for excess blood loss irrespective of the mode of delivery, even after adjusting for age-related complications such as leiomyoma, placenta previa, and low lying placenta.

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PubMed2003

Symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies.

OBJECTIVE: To determine the normogram for symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies and to examine whether fundus height and weight gain pattern are altered in women who give birth to twin infants complicated by fetal growth restriction (FGR). STUDY DESIGN: A retrospective review of the medical records of 186 twin gestations that had been followed at our institution together with 229 singleton pregnancies as a control. We examined maternal symphysis-fundus height, body weight gain and increase in body mass index (BMI) according to gestational age and compared them between women with and without FGR. RESULTS: As compared to women with singleton pregnancies, those with twins exhibited larger fundus height, larger weight gain and larger increase in BMI, all of which were observed from as early as 16-18 weeks of gestation until delivery. Mothers of twins with at least one FGR infant showed smaller fundus height, smaller weight gain and smaller increase in BMI as compared to those without. CONCLUSION: We constructed the normogram for symphysis-fundus height and weight gain pattern in Japanese twin gestations and determined the characteristic change in these parameters in FGR in women with twins. These results may be of use in identifying mothers of twins with FGR.

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PubMed2002

Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies.

BACKGROUND: It is not known whether antithrombin III activity and platelet count are more likely to decrease in women with twin pregnancies than singleton pregnancies. METHODS: We enrolled 56 consecutive women with twin pregnancies and 692 consecutive women with singleton pregnancies. Antithrombin III activity and platelet count were determined at 26-31 weeks and again at 32-40 weeks of gestation. Thrombin-antithrombin complex, and plasmin-alpha2 plasmin inhibitor complex were measured simultaneously in some women. RESULTS: In twin pregnancies, both antithrombin III activity (111 +/- 8.2%) and platelet count (244 +/- 60 x 109/l) at 28.6 +/- 1.0 weeks decreased over time to 91 +/- 12% and 205 +/- 59 x 109/l, respectively, at 35.2 +/- 1.2 weeks; these decreases were significantly greater than in singleton pregnancies. However, a small number of women with singleton pregnancies had a significant decrease in antithrombin III activity in the absence of preeclampsia. The serum thrombin-antithrombin complex was significantly higher in twin pregnancies than in singleton pregnancies (9.7 +/- 4.2 ng/ml vs. 6.7 +/- 4.4 ng/ml, respectively, p < 0.01), and this increase correlated significantly with the decrease in antithrombin III activity in twin pregnancies (r = -0.459, p < 0.001). CONCLUSIONS: Antithrombin III activity and platelet count show a greater decrease in twin than in singleton pregnancies, perhaps due to a greater increase in thrombin generation.

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PubMed2002

Recurrence risk of preterm birth due to preeclampsia.

There may be an increased risk of preterm birth due to preeclampsia among women whose previous pregnancies ended in preterm birth due to preeclampsia. We studied 1,130 women who delivered 2 successive singleton infants in our hospital, excluding women who delivered an abnormally formed infant during the study period. We reviewed the gestational week at delivery in these 2,260 pregnancies and found a total of 182 preterm deliveries (8.1%) by 156 women. The causes of preterm birth were reviewed. Failed tocolysis, including premature rupture of membranes and clinical chorioamnionitis, and preeclampsia accounted for 135 (74.2%) and 30 (16.5%) of the 182 preterm deliveries, respectively. Women whose 1st delivery was preterm had a 3.26 times (95% CI 2.21-4.79) higher risk of a subsequent preterm delivery than women whose 1st delivery was term (26/96 vs. 60/1,034). The risk of preeclampsia-related preterm delivery was 54.4 times (17.2 to 172.5) higher in women with a previous preeclampsia-related preterm delivery than in women with a previous term delivery (5/19 vs. 5/1034). Women who had a history of preeclampsia-related preterm birth had a greater risk of preeclampsia-related preterm birth in a subsequent pregnancy as compared with women with a previous term birth.

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PubMed2002

Vaginal lactobacilli and preterm birth.

OBJECTIVE: To assess the relationship between the absence of vaginal lactobacilli and preterm birth at < 33 weeks of gestation. METHODS: A prospective study of the vaginal flora in the second trimester was undertaken in 1958 women with singleton pregnancies. The contribution of various microorganisms to preterm delivery was analyzed using a multivariate-logistic regression model. RESULTS: Lactobacillus species were not cultured from 28% of 118 women who delivered at < 33 weeks, 10% of 224 women who delivered between 33 and 36 weeks, and 5% of 1616 women who delivered at > 37 weeks of gestation. Lactobacilli (odds ratio and 95% confidence interval: 0.15 [0.09 to 0.24]), Mycoplasma hominis (2.3 [1.0 to 5.4]), and glucose non-fermentative gram-negative rods (2.1 [1.0 to 4.2]) were identified as independent risk factors for preterm delivery at < 33 weeks of gestation. Absence of lactobacilli (sensitivity and positive predictive value: 28% and 25%) was a better predictor of preterm delivery at < 33 weeks of gestation than the presence of Mycoplasma hominis (7% and 13%, respectively) or glucose non-fermentative rods (9% and 11%). CONCLUSIONS: Although this was not a cohort study, results suggest that tests for determining the presence of vaginal lactobacilli may be clinically useful tools for identifying women at an increased risk of preterm delivery at < 33 weeks of gestation.

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