{"created":"2024-07-31T06:55:12.766420+00:00","id":2000493,"links":{},"metadata":{"_buckets":{"deposit":"285dcedd-a3f6-4c8f-9242-3be309ecfd1a"},"_deposit":{"created_by":50,"id":"2000493","owner":"50","owners":[50],"pid":{"revision_id":0,"type":"depid","value":"2000493"},"status":"published"},"_oai":{"id":"oai:kagawa-u.repo.nii.ac.jp:02000493","sets":["2:1720746067615:1722393749465"]},"author_link":["4297","4325","4335","4336","4282","2684","2759"],"control_number":"2000493","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-09-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"34","bibliographicPageStart":"31","bibliographicVolumeNumber":"20","bibliographic_titles":[{"bibliographic_title":"香川産科婦人科雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kagawa journal of obstetrics and gynecology : official journal of the Kagawa Society of Obstetrics and Gynecology","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"覚醒剤使用者は年々一般にも広がっており、妊婦の覚醒剤使用による胎児への影響が問題視されている。覚醒剤使用した妊婦症例を経験し、児への影響ばかりでなく、違法薬物届け出の是非や養育に関する対応で難渋したので、報告する。症例は33歳、5妊4産。約半年前に近医にて妊娠を確認し、予定日を決定していた。その後覚醒剤使用にて拘留され、妊娠25週に当科初診。母体・胎児に異常は認められなかった。以降受診なく、近医にて健診中と思われていた。妊娠40週2日、腹痛にて連絡あり、当院受診後未受診が判明し、来院を促した。未陣発で、血圧は正常、胎児に明らかな異常は認められなかった。1週間前に覚醒剤使用したと自己申告があり、薬物尿検査を提案するも同意が得られず帰宅した。翌日破水にて入院し、同意を得て施行した薬物尿検査でアンフェタミン弱陽性であった。同日3488gの男児をApgar Score 9/10（1分/5分）、臍帯動脈血pH7.258で経腟分娩。児は新生児科入院のうえ経過観察され、重篤な離脱症候群の発症を認めなかった。頭部MRI検査にて右小脳半球背側に異常影を認めたが、月齢6か月のフォローアップでは消失していた。養育に関しては、児の兄弟の育児放棄もあり、母の養育能力なしと判断して、児童相談所へ日齢20で一時預け、その後乳児院入所となった。アンフェタミンは交感神経終末に作用し血管収縮作用をもつ。催奇形性はないとされるが、子宮内胎児発育不全や妊娠高血圧症候群、胎盤早期剥離、早産、子宮内胎児死亡、新生児死亡の原因となり得る。また新生児期脳障害との関連についても指摘されている。妊婦に違法薬物使用が疑われた場合、周産期管理を行ううえで、できるだけ正確にその事実確認を行い、出生後も慎重に観察し、産婦人科と小児科、さらに行政機関と密な連携をとりあって、児の予後や養育環境の改善に努めることが重要である。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10001_heading_23":{"attribute_name":"見出し","attribute_value_mlt":[{"subitem_heading_banner_headline":"症例報告","subitem_heading_language":"ja"},{"subitem_heading_banner_headline":"[Case report]","subitem_heading_language":"en"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"香川産科婦人科学会","subitem_publisher_language":"ja"}]},"item_10001_relation_12":{"attribute_name":"論文ID（NAID）","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"40021715536","subitem_relation_type_select":"NAID"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type":"isPartOf","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.med.kagawa-u.ac.jp/~perigyne/ksog/journal/pdf/bukai20.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2185-1409","subitem_source_identifier_type":"EISSN"}]},"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_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open 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