| 特集名 | 透析医療におけるウーマン・ヘルス | |
|---|---|---|
| 題名 | 妊娠・出産 (2) 血液透析 | |
| 発刊年月 | 2003年 07月 | |
| 著者 | 高津 成子 | 幸町記念病院内科 |
| 著者 | 宮崎 雅史 | 幸町記念病院外科 |
| 著者 | 丸山 昌伸 | 岡山大学大学院医歯学総合研究科消化器腫瘍外科学 |
| 著者 | 岡 良成 | 幸町記念病院外科 |
| 著者 | 国米 欣明 | 幸町記念病院外科 |
| 著者 | 国友 桂一 | 幸町記念病院外科 |
| 【 要旨 】 | 1978年の本邦初例報告以来，透析患者の出産症例は61となった．61例中，死児10例であるが，1990年のrHuEPOの使用開始以降では出産例36例中，死児は2例にすぎず，計画的な妊娠による出産が5例，うち3例は不妊治療をしていた．妊娠管理上の注意点としては，1）十分な透析，2）貧血の改善，3）体重管理，4）(1) 高血圧，(2) 出血，(3) 流早産などの合併症対策があげられる．現在，透析患者の妊娠・出産は必ずしも禁忌ではなくなり，積極的に健康な生児を得る努力をする傾向にある． 今後は，挙児希望の強い透析患者には，許容条件を確認したうえで計画的に妊娠・出産できるように環境を整えることが望ましいと考える． |
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| Theme | Characteristic Problems in Managing Female Dialysis Patients | |
|---|---|---|
| Title | Pregnancy and delivery in patients receiving hemodialysis | |
| Author | Shigeko Takatsu | Department of Medicine, Saiwaicho-Kinen Hospital |
| Author | Masashi Miyazaki | Department of Surgery, Saiwaicho-Kinen Hospital |
| Author | Masanobu Maruyama | Department of Gastroenterological Surgery, Transplant, and Surgical Oncology, Okayama University Graduate School of Medicine and Dentistry |
| Author | Yoshinari Oka | Department of Surgery, Saiwaicho-Kinen Hospital |
| Author | Yoshiaki Kokumai | Department of Surgery, Saiwaicho-Kinen Hospital |
| Author | Keiichi Kunitomo | Department of Surgery, Saiwaicho-Kinen Hospital |
| [ Summary ] | 61 cases related to delivery in patients receiving hemodialysis have been reported, since the first successful case related to pregnancy and delivery of this type of patient in Japan was first reported in 1978. Although 10 out of 61 babies were dead, in 36 cases who delivered after 1990, 2 newborn were dead and 5 (cases) including of 3 infirtility therapy cases, were performed planned pregnancy and delivery. The conditions for successful management are as follows; 1) sufficient hemodialysis, 2) improvements in anemia, 3) control of dry weight, 4) countermeasures for complications such as (1) hypertension, (2) hemorrhaging, (3) abortion and/or premature birth. At this time, pregnancy and delivery in hemodialysis patients are not always considered impossible, and the there tends to be a positive outcome for the babies. From this time, it is to be desired that hemodialysis patients who wish to have a baby will deliver after a well planned pregnancy. |
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