No significant changes in preterm birth, low-birth-weight, and small-for-gestational-age infants during the first year of the COVID-19 pandemic in a rural area in Japan.

AIMS: To evaluate the coronavirus disease 2019 pandemic's impact on pregnancy outcomes in a Japanese rural area. METHODS: This retrospective study focused on the periods between March 1, 2020, and February 28, 2021 (during the coronavirus disease 2019 pandemic), and January 1, 2017, and December 31, 2019. Singleton pregnancies delivered at or after 22 gestational weeks were included. Preterm delivery, low-birth-weight, and small-for-gestational-age infant rates during the pandemic were compared to those in the preceding 3 years. RESULTS: In the pandemic and control groups, 1650 and 5762 pregnant women were included, respectively. Two pregnant women with coronavirus disease 2019 were identified (0.1%). There were no significant intergroup differences in preterm delivery rates (control, 4% vs. pandemic, 3.3%; difference: -0.7% [95% confidence interval: -1.7%-0.3%], p = 0.22). The low-birth-weight rate tended to decrease; however, the difference was insignificant (7.9% vs. 6.5%; difference: -1.4% [95% confidence interval: -2.8-0%], p = 0.06). The small-for-gestational-age infant rate was significantly lower in the pandemic than in the control group (7.3% vs. 5.2%; difference: -2.1% [95% confidence interval: -3.3-0.8%], p < 0.01). However, the interrupted time series analysis showed no significant trend. CONCLUSIONS: There were no significant changes in the rates of preterm delivery, low-birth-weight infants, and small-for-gestational-age infants during the pandemic's first year compared to those in the preceding 3 years. Behavioral changes, such as "stay-at-home" measures, may not improve pregnancy outcomes in Japan.

Uterine Trauma and Intrauterine Fetal Death Caused by Seatbelt Injury.

We present a case of uterine trauma and intrauterine fetal death caused by seatbelt injury. A 37-year-old primigravida at gestational week 24 was involved in a single-car accident when traveling as a front-seat passenger and wearing a three-point seatbelt. Fetal heart rate monitoring patterns revealed fetal demise, and computed tomography revealed intraperitoneal bleeding due to damage to the uterine vessels and placental lacerations across the seatbelt-compressed region. Intensive treatment, including transfusion therapy and surgical laparotomy, prevented the loss of her life but not that of the fetus. Seatbelt use can reduce the overall mortality associated with motor vehicle crashes. Pregnant women must be educated on the proper use of restraints while traveling in motor vehicles.

Efficacy and safety of triple therapy with aprepitant, palonosetron, and dexamethasone for preventing nausea and vomiting induced by cisplatin-based chemotherapy for gynecological cancer: KCOG-G1003 phase II trial.

PURPOSE: Prevention of chemotherapy-induced nausea and vomiting (CINV) is crucial for maintaining the quality of life of cancer patients. Female patients have been underrepresented in previous clinical studies of aprepitant or palonosetron. We performed a prospective multicenter study to investigate the efficacy and safety of triple therapy comprising these two agents and dexamethasone in female cancer patients receiving chemotherapy that included cisplatin (≥ 50 mg/m(2)). METHODS: Aprepitant was administered at a dose of 125 mg before chemotherapy on day 1 and at 80 mg on days 2 and 3. Palonosetron (0.75 mg) was given before chemotherapy on day 1. Dexamethasone was administered at a dose of 9.9 mg before chemotherapy on day 1 and at 6.6 mg on days 2-4. The primary endpoint was the the proportion of patients with a complete response (CR no vomiting and no use of rescue medication) throughout the overall period (0-120 h post-chemotherapy). RESULTS: Ninety-six women (median age 55 years) were enrolled. The overall CR rate was 54.2 %. CR was obtained during the acute phase (0-24 h post-chemotherapy) and the delayed phase (24-120 h post-chemotherapy) in 87.5 and 56.3 % of the patients, respectively. The most common adverse reactions were constipation and fatigue (reported by three patients each). CONCLUSIONS: Exhibition of a favorable overall CR rate over existing two-drug combinations suggests that the triple therapy regimen used in the present study is effective and tolerable in patients with gynecological malignancies receiving cisplatin-based chemotherapy. Female patients may have a higher risk of developing CINV.

A very rare case of an ectopic cervical intramural pregnancy.

OBJECTIVE: To report a case of a very rare ectopic cervical intramural pregnancy. DESIGN: Case report. SETTING: Prefectural hospital. PATIENT(S): A 22-year-old woman, gravida 1, para 0, was referred to our hospital with the suspicion of a cervical ectopic pregnancy (EP). Pelvic examination revealed an enlarged uterine cervix with no genital bleeding. We found a clear gestational sac (GS) and fetal heart beat in the anterior muscular layer of the uterine cervix by ultrasonography, and confirmed these findings by magnetic resonance imaging (MRI). INTERVENTION(S): We injected methotrexate (MTX) into the GS cavity and around the GS. One week later, the GS was removed surgically without massive bleeding. MAIN OUTCOME MEASURE(S): On the 11th postoperative day, she recovered and was discharged from our hospital. Her menstruation restarted on the 35th postoperative day. RESULT(S): We have shown a case of a very rare ectopic cervical intramural pregnancy with successful treatment. CONCLUSION(S): We have explained a case and successful treatment of a very rare ectopic cervical intramural pregnancy with clear GS and fetal heart beat. Our strategy was injecting MTX into the GS cavity and around the GS, then performing an operation to remove the GS.