{"created":"2023-05-15T10:01:57.358639+00:00","id":6646,"links":{},"metadata":{"_buckets":{"deposit":"bf1aba76-f15f-4365-aa1e-fbe7575f05e4"},"_deposit":{"created_by":5,"id":"6646","owner":"5","owners":[5],"pid":{"revision_id":0,"type":"depid","value":"6646"},"status":"published"},"_oai":{"id":"oai:miyazaki-u.repo.nii.ac.jp:00006646","sets":["72","72:30"]},"author_link":["34205","34209","9611","34206","2814","7768","34210","8140","34211","34208","8187","8139","7929","34207","8142","8158"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2009-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"60","bibliographicPageStart":"55","bibliographicVolumeNumber":"33","bibliographic_titles":[{"bibliographic_title":"宮崎県医師会医学会誌"},{"bibliographic_title":"The Journal of the Miyazaki Medical Association","bibliographic_titleLang":"en"}]}]},"item_10001_description_19":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は，透析歴17年（原疾患IgA腎症）の40歳女性。2007年12月妊娠７週と診断された。2008年１月妊娠11週で治療方針検討のため当院産婦人科へ入院した。高年初産の透析患者であったが，本人が挙児希望され，妊娠15週より20週までは，維持透析施設で週16時間透析（１回４時間，週４回）を行った。妊娠21週より妊娠管理目的で再入院し，週20時間透析（１回５時間，週４回），25週以降分娩まで週24時間透析（１回４時間，週６回）を行った。透析前のBUNは50㎎/dl以下で推移した。腎性貧血に関しては，エリスロポエチン（rHuEPO），静注用鉄剤を使用しHb 10g/dl前後で推移した。ドライ体重（DW）は，妊娠21週以降500g/週の増加を目安に行い，ヒト心房性Na利尿ペプチド（hANP），エコーによる下大静脈（IVC）径，下大静脈径安静呼気時最大径（IVCe），呼気時最小径（IVCi），虚脱度（collapsibility index : CI＝IVCe−IVCi/IVCe），血圧を参考にした。妊娠30週より，hANP 100pg/ml以上，IVC径拡大傾向，血圧上昇傾向となりDW増加を抑えた。妊娠34週で著明な体液過剰はないものの，高血圧のコントロールが不良となり，妊娠高血圧症候群を呈していると考えられた。妊娠34週２日に帝王切開術を施行し，児の体重は1305g，Apgar scoreは１分後８点，５分後９点であった。尿道下裂があり，泌尿器科，小児科で経過観察中であるが，児は現在まで発達，発育は良好である。\n　以前は透析患者の妊娠継続については，否定的に考えられていたが，十分な透析，厳格な体液量管理，貧血の管理で，産科の協力のもとに分娩（児生存）まで至ることが可能になってきた。透析患者の分娩報告は増えており，妊娠透析患者の管理に関する知識は重要であると考える。","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"宮崎県医師会"}]},"item_10001_rights_15":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"宮崎県医師会"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03898288","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorAffiliations":[{"affiliationNameIdentifiers":[{"affiliationNameIdentifier":"","affiliationNameIdentifierScheme":"ISNI","affiliationNameIdentifierURI":"http://www.isni.org/isni/"}],"affiliationNames":[{"affiliationName":"","affiliationNameLang":"ja"}]}],"creatorNames":[{"creatorName":"Iwatsubo, 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