{"created":"2023-06-20T14:29:06.013662+00:00","id":5100,"links":{},"metadata":{"_buckets":{"deposit":"b70eb53c-c379-4022-98ba-30a0e9fd73f7"},"_deposit":{"created_by":14,"id":"5100","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"5100"},"status":"published"},"_oai":{"id":"oai:dmu.repo.nii.ac.jp:00005100","sets":["81:226"]},"author_link":["46644"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-10-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"275","bibliographicPageStart":"269","bibliographicVolumeNumber":"48","bibliographic_titles":[{"bibliographic_title":"Dokkyo Journal of Medical Sciences"}]}]},"item_10001_description_34":{"attribute_name":"要旨","attribute_value_mlt":[{"subitem_description":"・妊産婦における，SARS-CoV-2ウイルス重症感染症であるCOVID-19への対処には，呼吸器系の症状だけではなく，妊娠による全身の生理学的変化および胎児，胎盤，乳腺の存在と機能に留意する必要がある．\n・妊産婦のCOVID-19は重症化しやすく高リスクである．妊娠中の免疫系はmodulationされ胎児への免疫寛容が生じており，非妊娠時と同様ではない．\n・妊娠第3三半期の発症が多いとされている．全体での死亡率は低いが産褥期に重症化したものの死亡率はSARS, MERSに匹敵する．\n・妊娠中に肺炎，ARDSなど母体低酸素となった場合は胎盤のガス交換も阻害されるため，胎児機能不全となり得る．母体低酸素では子宮収縮が誘発される懸念や，胎児死亡の可能性も考えられる．\n・分娩様式として満期の経腟分娩は不可能ではないが，COVID-19の病勢や施設の感染拡大防止の観点から帝王切開による分娩が結果として選択されるケースが多い．\n・胎児への垂直感染の頻度は小さい．しかし母体が重症化した場合の胎児・新生児予後は悪い可能性がある．重症例では免疫寛容の破綻，アンジオテンシン変換酵素2（ACE2）活性低下による母児への影響が懸念される．\n・母乳を避ける根拠はないが，感染予防処置は必要である．\n・妊産婦へのワクチン投与は初期をふくめて禁忌ではないが，いまだに安全性を確証するデータは得られていない．","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"獨協医学会"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00629581","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03855023","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_24":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"獨協医科大学病院 総合周産期母子医療センター 産科部門, 獨協医科大学 産科婦人科学"}]},"item_10001_text_29":{"attribute_name":"特集名(日)","attribute_value_mlt":[{"subitem_text_value":"新型コロナウイルス感染症2019"}]},"item_10001_text_30":{"attribute_name":"特集名(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Coronavirus Disease 2019"}]},"item_10001_text_33":{"attribute_name":"記事種別","attribute_value_mlt":[{"subitem_text_value":"特集"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"宮下, 進"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-02-10"}],"displaytype":"detail","filename":"DJMS-48-3-18.pdf","filesize":[{"value":"677.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"DJMS-48-3-宮下-本文","url":"https://dmu.repo.nii.ac.jp/record/5100/files/DJMS-48-3-18.pdf"},"version_id":"9379383a-9be2-4c34-9104-221465811970"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"コロナ禍における周産期診療","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"コロナ禍における周産期診療"},{"subitem_title":"Perinatal Management on the 2019 Novel Coronavirus（COVID-19）Pandemic","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["226"],"publish_date":"2022-02-10","publish_status":"0","recid":"5100","relation_version_is_last":true,"title":["コロナ禍における周産期診療"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-06-20T14:50:06.202745+00:00"}