Ikenoue, Satoru

写真a

Affiliation

School of Medicine, Department of Obstetrics and Gynecology (Obstetrics) Perinatology （Shinanomachi）

Position

Assistant Professor/Senior Assistant Professor

External Links
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Research Keywords 【 Display / hide 】

  • Developmental Origins of Health and Disease

  • Fetal body composition

  • Fetal Physiology

  • Fetal ultrasonography

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Research Themes 【 Display / hide 】

  • Fetal body composition, 

    2014.04
    -
    Present

    　View Summary

    Evaluation of fetal body composition and fat deposition using fetal ultrasonography

  • Fetal liver blood flow, 

    2014.04
    -
    Present

    　View Summary

    Association between fetal liver blood flow volume and fetal body composition and newborn adiposity

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Proposed Theme of Joint Research 【 Display / hide 】

  • Primary prevention of ealy onset metabolic syndrome from intrauterine period

    Interested in joint research with industry (including private organizations, etc.),  Desired form： Technical Consultation, Funded Research, Cooperative Research

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Papers 【 Display / hide 】

  • 染色体異常を伴わない胎児臍帯ヘルニアの2例

    木村 由実子, 玉井 順子, 春日 義史, 秋田 啓介, 田中 邦生, 葉室 明香, 福間 優花, 長谷川 慶太, 大谷 利光, 池ノ上 学, 青木 大輔, 田中 守

    東京産科婦人科学会会誌 （(一社)東京産科婦人科学会)  72 （ 2 ） 327 - 331 2023.04

    ISSN  2186-0599

    　View Summary

    緒言:今回我々は染色体異常を伴わない胎児臍帯ヘルニアの2例の周産期管理を行ったので報告する.症例1は41歳,1妊0産.体外受精-胚移植により妊娠成立し,妊娠13週に臍帯ヘルニアを指摘された.症例2は40歳,1妊0産.自然妊娠にて妊娠成立し,妊娠12週に胎児腹部腫瘤を指摘された.いずれも妊娠16週の羊水検査で正常核型であり,超音波断層法では肝脱出型臍帯ヘルニアと単一臍帯動脈以外の形態異常は指摘されなかった.出生後の精査にて症例1は食道閉鎖,鎖肛,軟口蓋裂,左多合指症等を認めたためVATER連合,症例2は耳介の形態や高インスリン血症からBeckwith-Wiedemann症候群が疑われた.結論:染色体異常を伴っていない臍帯ヘルニアでは,他の症候群の1症候であり出生後に判明する場合があることを念頭に胎児の慎重な観察と家族への十分な説明を行うことが望ましいと考えられた.(著者抄録)

  • Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index.

    Keita Hasegawa, Satoru Ikenoue, Yuya Tanaka, Maki Oishi, Toyohide Endo, Yu Sato, Ryota Ishii, Yoshifumi Kasuga, Daigo Ochiai, Mamoru Tanaka

    Journal of clinical medicine （Journal of Clinical Medicine)  12 （ 3 ）  2023.02

    ISSN  2077-0383

    　View Summary

    This study aimed to investigate the diagnostic accuracy of the placenta accreta index (PAI) for predicting placenta accreta spectrum (PAS) in women with placenta previa. We analyzed 33 pregnancies with placenta previa at Keio University Hospital. The PAI was assessed in the early third trimester, and PAS was diagnosed histologically or clinically defined as retained placenta after manual removal attempts. The PAI and incidence of PAS were analyzed. Ten women (30%) were diagnosed with PAS and had higher volumes of perioperative bleeding (p = 0.016), higher rate of requiring uterine artery embolization (p = 0.005), and peripartum hysterectomy (p = 0.0002) than women without PAS. A PAI > 2 was the most useful cut-off point for predicting PAS and was more sensitive than prediction values using traditional evaluation (history of cesarean section and placental location). Post-hoc analysis revealed a higher rate of previous history of cesarean delivery (30% vs. 4.4%, p = 0.038), severe placental lacunae (≥grade2) (70% vs. 8.7%, p = 0.0003), thin myometrial thickness (90% vs. 22%, p = 0.0003), anterior placenta (100% vs. 30%, p = 0.0002), and presence of bridging vessels (30% vs. 0%, p = 0.0059) in PAS women. PAI could help predict the outcomes of women with placenta previa with and without a history of cesarean delivery to reduce PAS-induced perinatal complications.

  • Obstetric outcomes after medroxyprogesterone acetate treatment for early stage endometrial cancer or atypical endometrial hyperplasia: a single hospital-based study.

    Oishi M, Kasuga Y, Fukuma Y, Hamuro A, Tamai J, Tanaka Y, Hasegawa K, Yoshimura T, Ikenoue S, Ochiai D, Yamagami W, Tanaka M

    International journal of clinical oncology （International Journal of Clinical Oncology)  28 （ 4 ） 587 - 591 2023.01

    ISSN  1341-9625

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    BACKGROUND: To investigate perinatal outcomes in pregnancy after high-dose medroxyprogesterone acetate (MPA) therapy for early stage endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) and to determine whether pregnancy after MPA therapy is at a higher risk of placenta accreta. METHODS: Data of 51 pregnancies in 46 women who received MPA therapy for EC or AEH and delivered after 22 weeks of gestation at Keio University Hospital were reviewed. A retrospective matched case-control study was performed to determine the risk of placenta accreta in pregnancy after MPA therapy compared with singleton pregnancies without any history of maternal malignancy treatments. RESULTS: The incidence of placenta accreta was higher in the MPA group than in the control group (15.7 vs. 0%, p = 0.0058). However, no differences in other perinatal outcomes were observed between groups. While gestational weeks at delivery in the MPA group were later than those in the control group (p = 0.0058), no difference in the incidence of preterm delivery was recorded between groups. In the MPA therapy group, the number of patients who underwent ≥ 6 dilation and curettage (D&C) was higher in the placenta accreta group than in the non-placenta accreta group (50.0 vs. 14.0%, p = 0.018). Patients with ≥ 6 D&Cs demonstrated a 6.0-fold increased risk of placenta accreta (p = 0.043, 95% CI 1.05-34.1) than those receiving ≤ 3 D&Cs. CONCLUSION: Pregnancy after MPA therapy is associated with a high risk of placenta accreta. In cases in which the frequency of D&C is high, placenta accreta should be considered.

  • Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study

    Jose Villar, Constanza P Soto Conti, Robert B Gunier, Shabina Ariff, Rachel Craik, Paolo I Cavoretto, Stephen Rauch, Serena Gandino, Ricardo Nieto, Adele Winsey, Camilla Menis, Gabriel B Rodriguez, Valeria Savasi, Niyazi Tug, Sonia Deantoni, Marta Fabre, Begoña Martinez de Tejada, Maria Jose Rodriguez-Sibaja, Stefania Livio, Raffaele Napolitano, Nerea Maiz, Helena Sobrero, Ashley Peterson, Philippe Deruelle, Carolina Giudice, Jagjit S Teji, Roberto A Casale, Laurent J Salomon, Federico Prefumo, Leila Cheikh Ismail, Michael G Gravett, Marynéa Vale, Valeria Hernández, Loïc Sentilhes, Sarah R Easter, Carola Capelli, Emily Marler, Daniela M Cáceres, Guadalupe Albornoz Crespo, Ernawati Ernawati, Michal Lipschuetz, Ken Takahashi, Carmen Vecchiarelli, Teresa Hubka, Satoru Ikenoue, Gabriela Tavchioska, Babagana Bako, Adejumoke I Ayede, Brenda Eskenazi, Jim G Thornton, Zulfiqar A Bhutta, Stephen H Kennedy, Aris T Papageorghiou

    The Lancet （Elsevier BV)  401 （ 10375 ） 447 - 457 2023.01

    ISSN  0140-6736

    　View Summary

    Background: In 2021, we showed an increased risk associated with COVID-19 in pregnancy. Since then, the SARS-CoV-2 virus has undergone genetic mutations. We aimed to examine the effects on maternal and perinatal outcomes of COVID-19 during pregnancy, and evaluate vaccine effectiveness, when omicron (B.1.1.529) was the variant of concern. Methods: INTERCOVID-2022 is a large, prospective, observational study, involving 41 hospitals across 18 countries. Each woman with real-time PCR or rapid test, laboratory-confirmed COVID-19 in pregnancy was compared with two unmatched women without a COVID-19 diagnosis who were recruited concomitantly and consecutively in pregnancy or at delivery. Mother and neonate dyads were followed until hospital discharge. Primary outcomes were maternal morbidity and mortality index (MMMI), severe neonatal morbidity index (SNMI), and severe perinatal morbidity and mortality index (SPMMI). Vaccine effectiveness was estimated, adjusted by maternal risk profile. Findings: We enrolled 4618 pregnant women from Nov 27, 2021 (the day after WHO declared omicron a variant of concern), to June 30, 2022: 1545 (33%) women had a COVID-19 diagnosis (median gestation 36·7 weeks [IQR 29·0–38·9]) and 3073 (67%) women, with similar demographic characteristics, did not have a COVID-19 diagnosis. Overall, women with a diagnosis had an increased risk for MMMI (relative risk [RR] 1·16 [95% CI 1·03–1·31]) and SPMMI (RR 1·21 [95% CI 1·00–1·46]). Women with a diagnosis, compared with those without a diagnosis, also had increased risks of SNMI (RR 1·23 [95% CI 0·88–1·71]), although the lower bounds of the 95% CI crossed unity. Unvaccinated women with a COVID-19 diagnosis had a greater risk of MMMI (RR 1·36 [95% CI 1·12–1·65]). Severe COVID-19 symptoms in the total sample increased the risk of severe maternal complications (RR 2·51 [95% CI 1·84–3·43]), perinatal complications (RR 1·84 [95% CI 1·02–3·34]), and referral, intensive care unit (ICU) admission, or death (RR 11·83 [95% CI 6·67–20·97]). Severe COVID-19 symptoms in unvaccinated women increased the risk of MMMI (RR 2·88 [95% CI 2·02–4·12]) and referral, ICU admission, or death (RR 20·82 [95% CI 10·44–41·54]). 2886 (63%) of 4618 total participants had at least a single dose of any vaccine, and 2476 (54%) of 4618 had either complete or booster doses. Vaccine effectiveness (all vaccines combined) for severe complications of COVID-19 for all women with a complete regimen was 48% (95% CI 22–65) and 76% (47–89) after a booster dose. For women with a COVID-19 diagnosis, vaccine effectiveness of all vaccines combined for women with a complete regimen was 74% (95% CI 48–87) and 91% (65–98) after a booster dose. Interpretation: COVID-19 in pregnancy, during the first 6 months of omicron as the variant of concern, was associated with increased risk of severe maternal morbidity and mortality, especially among symptomatic and unvaccinated women. Women with complete or boosted vaccine doses had reduced risk for severe symptoms, complications, and death. Vaccination coverage among pregnant women remains a priority. Funding: None.

  • Risk factors of neonatal hypoglycemia in neonates born to mothers with gestational diabetes.

    Takeshi Arimitsu, Yoshifumi Kasuga, Satoru Ikenoue, Yoshifumi Saisho, Mariko Hida, Jun Yoshino, Hiroshi Itoh, Mamoru Tanaka, Daigo Ochiai

    Endocrine journal （Endocrine Journal)  70 （ 5 ） 511 - 517 2023

    ISSN  09188959

    　View Summary

    Hypoglycemia is one of the most significant problems in neonates born to mothers with gestational diabetes (GDM). This study aimed to identify novel predictors of hypoglycemia in neonates born to mothers with GDM. A total of 443 term singleton infants from mothers diagnosed with GDM and cared for at Keio University Hospital between January 2013 and December 2019 were included in this study. Neonatal hypoglycemia was defined as hypoglycemia of less than 47 mg/dL at 1 or 2 or 4 h after birth, according to previous studies. Among 443 full-term singleton neonates born to mothers with GDM, 200 developed hypoglycemia (45%). Gestational weight gain (GWG), HbA1c at 1st trimester, HbA1c at GDM diagnosis, and the incidence of insulin therapy in the neonatal hypoglycemia group were significantly higher than those in the non-neonatal hypoglycemia group (p = 0.016, p = 0.032, p = 0.011, and p = 0.017, respectively). Regarding the multiple regression analysis adjusted for nulliparity, GWG, and gestational weeks at delivery, the odds ratio for maternal HbA1c ≥5.2% at 1st trimester was 1.63 (p = 0.034), and maternal insulin therapy during pregnancy was 1.72 (p = 0.015). In conclusion, HbA1c in the 1st trimester and insulin therapy during pregnancy were good predictors of hypoglycemia in neonates born to GDM mothers, especially when their HbA1c was 5.2% or more. Further research will be necessary to improve the perinatal management of hypoglycemia.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

  • 胎児肝血流量による胎児発育不全児の周産期予後の予測

    池ノ上 学

    東京産婦人科医会誌 ((一社)東京産婦人科医会)   ( 56 ) 81 - 83 2023.08

  • 【人生最初の1000日間と疾患感受性】胎児発育からみた次世代の健康

    池ノ上 学

    Medical Science Digest ((株)ニュー・サイエンス社)  49 ( 8 ) 410 - 413 2023.07

    ISSN  1347-4340

    　View Summary

    出生体重は周産期予後の予測因子であるだけでなく,メタボリックシンドロームをはじめとした児の長期予後とも関連する(DOHaD)。これまでに新生児期の体脂肪率と,小児期の体脂肪率や肥満との関連が既に報告されている。さらに,妊娠後期における胎児脂肪量や肝血流量が新生児体脂肪率の有用な予測因子であることが,近年明らかとなっており,肥満の起原は胎児期まで遡る可能性がある。今後,胎児脂肪量の規定因子を解明していくことで,児の周産期予後のみでなく長期予後に関連する病態の解明や,早期発症メタボリックシンドロームの一次予防へとつながる可能性がある。(著者抄録)

  • 当院のフェンタニル静脈内投与法による和痛分娩の周産期転帰の検討

    長谷川 慶太, 春日 義史, 秋田 啓介, 田中 邦生, 福間 優花, 玉井 順子, 葉室 明香, 田中 雄也, 大谷 利光, 池ノ上 学, 田中 守

    日本周産期・新生児医学会雑誌 ((一社)日本周産期・新生児医学会)  59 ( Suppl.1 ) P299 - P299 2023.06

    ISSN  1348-964X

  • 当院における高用量黄体ホルモン療法後妊娠における癒着胎盤リスク因子に関する検討

    大石 真希, 春日 義史, 田中 雄也, 長谷川 慶太, 遠藤 豊英, 大谷 利光, 池ノ上 学, 田中 守

    日本周産期・新生児医学会雑誌 ((一社)日本周産期・新生児医学会)  59 ( Suppl.1 ) P416 - P416 2023.06

    ISSN  1348-964X

  • 当院で経験した子宮破裂8例に関する検討

    秋田 啓介, 春日 義史, 田中 邦生, 玉井 順子, 葉室 明香, 福間 優花, 田中 雄也, 長谷川 慶太, 大谷 利光, 池ノ上 学, 田中 守

    日本周産期・新生児医学会雑誌 ((一社)日本周産期・新生児医学会)  59 ( Suppl.1 ) P329 - P329 2023.06

    ISSN  1348-964X

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Presentations 【 Display / hide 】

  • 当院における広汎性子宮頸部摘出術後妊娠に対する取り組み

    春日 義史, 池ノ上 学, 西尾 浩, 仲村 勝, 落合 大吾, 岩田 卓, 田中 京子, 飛騨 麻里子, 浜谷 敏生, 宮越 敬, 勝又 徳子, 菊地 敦子, 田中 守, 青木 大輔

    日本周産期・新生児医学会雑誌, 

    2020.01
    , 

    (一社)日本周産期・新生児医学会

  • Sonographic evaluation of fetal fractional limb volume across gestation in gestational diabetes

    Satoru Ikenoue, Yohei Akiba, Toyohide Endo, Yoshifumi Kasuga, Daigo Ochiai, Kei Miyakoshi, Kazumi Yakubo, Mamoru Tanaka

    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 

    2020.01
    , 

    MOSBY-ELSEVIER

  • やせ妊娠糖尿病合併妊婦の糖代謝および臨床像に関する検討

    春日 義史, 宮越 敬, 佐藤 佑, 池ノ上 学, 税所 芳史, 田中 守

    糖尿病と妊娠, 

    2019.11
    , 

    (一社)日本糖尿病・妊娠学会

  • 新基準妊娠糖尿病に対する血糖管理の意義を胎児エピゲノムの観点から考える

    春日 義史, 河合 智子, 池ノ上 学, 落合 大吾, 税所 芳史, 飛彈 麻里子, 宮越 敬, 秦 健一郎, 田中 守

    日本女性栄養・代謝学会学術集会プログラム・抄録集, 

    2019.09
    , 

    日本女性栄養・代謝学会

  • 妊娠中に発症した脳動脈解離の1例

    秋田 啓介, 玉川 真澄, 上條 慎太郎, 春日 義史, 池ノ上 学, 落合 大吾, 宮越 敬, 田中 守

    日本妊娠高血圧学会雑誌, 

    2019.09
    , 

    日本妊娠高血圧学会

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • 胎児発育不全における胎児肝血流量および軟部組織量を用いた周産期予後の予測

    2022.04
    -
    2024.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Early-Career Scientists, Principal investigator

    　View Summary

    胎児発育不全(FGR)は、周産期予後不良因子の一つであり、また生活習慣病などの児の長期予後にも関連する。FGRの管理や娩出時期については確立されたエビデンスは未だ乏しく、FGRの予後予測因子の解明が望まれている。 近年、胎児肝血流量が胎児の軟部組織量(脂肪量・骨格筋量)に関連し、胎児発育の予測に有用であることが報告されている。そこで本研究では、FGRにおいて肝血流量および軟部組織量を測定し、周産期予後との関連について検討を行う。胎児肝血流量や軟部組織量が周産期予後に関する新たなパラメーターとなれば、FGRにおける周産期予後の改善へ繋がる可能性がある。

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Courses Taught 【 Display / hide 】

  • PATHOPHYSIOLOGICAL ISSUES IN ACUTE CARE

    2024

  • LECTURE SERIES, OBSTETRICS

    2024

  • PATHOPHYSIOLOGICAL ISSUES IN ACUTE CARE

    2023

  • LECTURE SERIES, OBSTETRICS

    2023

  • LECTURE SERIES, OBSTETRICS

    2022

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