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Biomedical subjects

Ken-ichi Shukunami

Publications and source records attributed to Ken-ichi Shukunami.

29 records · Page 2Linked to original sources
PubMed2005

A small-angled thin edge of the placenta predicts abnormal placentation at delivery.

OBJECTIVE: This study was intended to determine the relationship between the angle of the lower placental edge in early pregnancy and the previa/low-lying placenta at delivery. METHODS: We used transvaginal sonography to consecutively screen 2543 singleton pregnancies. All subjects were scanned during the period of gestation between 12 weeks 0 days and 15 weeks 6 days. The angle of the lower placental edge was measured when the placenta covered the internal cervical os. These cases were followed sonographically until term. RESULTS: Of 168 cases in which the internal cervical os was covered at screening, 9 showed previa/low-lying placenta at delivery (previa/low-lying group). The remaining 159 showed no abnormal placentation (nonprevia group). There were significantly fewer degrees of angle in the previa/low-lying group than in the nonprevia group (P < .05). For the previa/low-lying group, the arithmetic mean, median, and SD values of the angles were 60.8 degrees , 50.0 degrees , and 9.8 degrees , respectively. For the nonprevia group, those values were 103.4 degrees , 103.0 degrees , and 31.8 degrees , respectively. Data based on the cutoff number of the angle of 74 degrees indicated the following: sensitivity of placenta previa or low-lying placenta at term, 100% (9 of 9); false-positive rate, 23% (36 of 159); positive predictive value, 20% (9 of 45); and negative predictive value, 100% (123 of 123). CONCLUSIONS: The angle between the placental-uterine interface and fetal placental surface can be evaluated during early pregnancy. It appears to accurately predict placenta previa or low-lying placenta at term gestation with a sensitivity of 100%, a false-positive rate of 23%, and a high negative predictive value of 100%, which would allow for elimination of some of the multiple scans.

Delivery, Obstetric↗
PubMed2004

A subamniotic hematoma resembling a deflated balloon.

Subamniotic hematoma is a placental pathological lesion resulting from the rupture of allantochorionic vessels. Some of them decrease in size during pregnancy. However, the relation between the reduction of the lesions during pregnancy and the structure of the placenta at delivery has not been previously reported. We report a case of subamniotic hematoma detected prenatally, which decreased in size during the third trimester, and presented with a cystic structure resembling a deflated balloon at delivery, and also review the literature of the placental surface cysts detected by prenatal ultrasound.

Adult↗
PubMed2004

Recanalization of a fallopian tube after detorsion of twisted adnexa: report of a case with follow-up by repeat hysterosalpingography.

BACKGROUND: Detorsion and cystectomy of twisted adnexa have been performed in young women. However, identification was incomplete, and the function of the affected tube was not investigated. CASE: A 23-year-old, nulligravid woman with an acute abdomen was diagnosed with adnexal torsion. An emergency laparotomy revealed that both ovaries were 12x9x9 cm. the right adnexa were twisted and bluish black. Detorsion of the twisted lesion and ipsilateral fallopian tube was performed, with subsequent cystectomy of both lesions. Hysterosalpingography on the 14th postoperative day showed right tubal obstruction; 6 months postoperatively, repeat hysterosalpingography revealed patency of the right tube. CONCLUSION: At least several months may be required for functional recovery of an untwisted tube. For that reason, postoperative repeat hysterosalpingography is a useful method for follow-up of function in an untwisted tube.

Abdomen, Acute↗
PubMedDate not supplied

Management for neonatal aspiration syndrome caused by vernix caseosa.

OBJECTIVE: To clarify resuscitation methods against the lethal vernix caseosa aspiration syndrome. METHOD: A single case report with a literature review. RESULTS: Our case report was associated with aspiration syndrome caused by an airway obstruction of vernix caseosa: a proteolipid biofilm synthesized by the fetus. A 23-year-old woman normally delivered a mature infant at term. The infantile oral cavity was filled with numerous aggregates of vernix caseosa. Two hours after his birth, the infant died from respiratory insufficiency. We discuss the difference between management of our case and the previously reported case. CONCLUSION: Pregnant women with a diffuse pattern of high-level echoes in prenatal ultrasonography, suggesting the presence of massive vernix caseosa, should be transferred to a well-equipped institution that can administer inhaled nitric oxide and extracorporeal membrane oxygenation.

Adult↗