{"created":"2023-05-15T09:44:18.525762+00:00","id":4923,"links":{},"metadata":{"_buckets":{"deposit":"63849f45-c443-4f3a-b8b3-b95f50aa92bc"},"_deposit":{"created_by":11,"id":"4923","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"4923"},"status":"published"},"_oai":{"id":"oai:kagawa-u.repo.nii.ac.jp:00004923","sets":["2:48:662"]},"author_link":["577","673","706","1106","2297","2897","1617"],"control_number":"4923","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2001-09-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"32","bibliographicPageStart":"27","bibliographicVolumeNumber":"3","bibliographic_titles":[{"bibliographic_title":"日本産科婦人科学会香川地方部会雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kagawa journal of obstetrics and gynecology","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"今回我々は、妊娠中期に急性虫垂炎を発症し、早産となった後、母体が敗血症を来し、児は先天性肺炎にて新生児死亡に至った一例を経験したので報告する。症例は25歳、初産婦。妊娠24週5日、急性虫垂炎の診断にて、他院外科にて虫垂切除術を行った。壊死性虫垂炎のため術中、壊死部の一部穿孔が認められた。術後、麻痺性イレウス症状を繰り返し、超音波、MRIなどで腹腔内に嚢胞状の液体貯留像認め、膿瘍形成の可能性も考慮し当院外科に紹介転院となった。嚢胞内容液の穿刺にて、内容は漿液性で細菌培養検査は陰性であり、CRP、白血球も正常化したため、退院のうえ外来経過観察とした。退院後6日目（妊娠29週3日）、子宮収縮を頻回に認めたため、切迫早産にて入院し、安静および塩酸リトドリン持続点滴にて治療を施行した。入院後CRPは18.4と上昇し、発熱も認められ、更に子宮収縮抑制も困難となり、妊娠30週3日、経膣分娩に至った。新生児は1779gの男児で、分娩時胎児心拍モニタリングにて異常は認められなかったが、Apgar Score はl分後1点、5分後2点であり出生後直ちに挿管した。人工換気で管理するも子宮内感染と思われる肺炎症状が強く、出生後2日目に新生児死亡となった。母体は分娩後もCRP、白血球の上昇が続き、血液培養検査で E. coli 陽性で敗血症と診断した。FOY、AT-IIIなど抗DIC治療、イミペネム、ガンマグロプリン製剤による強力な抗感染療法を行い、母体の感染症状は改善した。腹腔内の貯留像も消失し、CRPも陰性化し、産褥16日目に軽快退院となった。","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","subitem_heading_language":"ja"},{"subitem_heading_banner_headline":"[Case 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