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A basic study on the reaction system of amniotic fluid fetal component and maternal for the pathogenesis of amniotic fluid embolism

Research Project

Project/Area Number 18K09225
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56040:Obstetrics and gynecology-related
Research InstitutionHamamatsu University School of Medicine

Principal Investigator

Tamura Naoaki  浜松医科大学, 医学部, 講師 (90402370)

Co-Investigator(Kenkyū-buntansha) 金山 尚裕  浜松医科大学, 医学部, 副学長 (70204550)
伊東 宏晃  浜松医科大学, 医学部, 教授 (70263085)
Project Period (FY) 2018-04-01 – 2021-03-31
Project Status Completed (Fiscal Year 2020)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords羊水塞栓症 / 播種性血管内凝固 / 凝固線溶系 / 血栓 / 血液凝固線溶系 / 免疫反応 / 血液凝固反応
Outline of Final Research Achievements

We analysed the direct reaction between amniotic fluid and maternal blood by utilizing Rotational thromboelastometry (ROTEM). Our data suggests amniotic fluid accelerated thrombin production and activated platelet aggregation without inducing hyperfibrinolysis in whole blood. The activated tissue factor tissue factor pathway with amniotic fluid produced soft and fragile clots due to its influence on platelets.
We also measured ETP with four different amounts of amniotic fluid followed by the calculation of APC-sr. Our result indicates amniotic fluid reduced susceptibility to APC and attenuated the maternal APC anti-coagulation system, which may have partly contributed to enhanced maternal blood coagulation caused by amniotic fluid contamination.

Academic Significance and Societal Importance of the Research Achievements

羊水と母体血液の反応として、羊水は血液凝固反応を促進し血小板凝集を活性化したが線溶亢進を誘導しなかった。羊水によってさらに活性化された組織因子経路のもとでは血小板に影響し、脆弱な血餅がつくられた。これらの結果は、羊水塞栓症による肺動脈塞栓のメカニズムとして、羊水・胎児成分による機械的閉塞だけでなく、分娩後早期の組織因子経路活性化に伴う播種性血管内凝固症候群および血栓塞栓が関与することを示唆しており、羊水塞栓症における心肺虚脱の病態解明につながるものと期待される。

Report

(4 results)
  • 2020 Annual Research Report   Final Research Report ( PDF )
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (9 results)

All 2020 2019 2018

All Journal Article (7 results) (of which Peer Reviewed: 7 results,  Open Access: 4 results) Presentation (2 results) (of which Invited: 2 results)

  • [Journal Article] Gross appearance of the fetal membrane on the placental surface is associated with histological chorioamnionitis and neonatal respiratory disorders2020

    • Author(s)
      Horikoshi Yoshimasa、Yaguchi Chizuko、Furuta-Isomura Naomi、Itoh Toshiya、Kawai Kenta、Oda Tomoaki、Matsumoto Masako、Kohmura-Kobayashi Yukiko、Tamura Naoaki、Uchida Toshiyuki、Kanayama Naohiro、Itoh Hiroaki
    • Journal Title

      PLOS ONE

      Volume: 15 Issue: 11 Pages: 0242579-0242579

    • DOI

      10.1371/journal.pone.0242579

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Acute inflammation in the uterine isthmus coincides with postpartum acute myometritis in the uterine body involving refractory postpartum hemorrhage of unknown etiology after cesarean delivery.2020

    • Author(s)
      Jain D, Oda T, Kohmura-Kobayashi Y, Furuta-Isomura N, Yaguchi C, Uchida T, Suzuki K, Itoh H, Kanayama N, Tamura N.
    • Journal Title

      J Reprod Immunol.

      Volume: 139 Pages: 103116-103116

    • DOI

      10.1016/j.jri.2020.103116

    • Related Report
      2020 Annual Research Report 2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] The fetal/placental weight ratio is associated with the incidence of atopic dermatitis in female infants during the first 14?months: The Hamamatsu Birth Cohort for Mothers and Children (HBC Study)2020

    • Author(s)
      Matsumoto Masako、Tsuchiya Kenji J.、Yaguchi Chizuko、Horikoshi Yoshimasa、Furuta-Isomura Naomi、Oda Tomoaki、Kohmura-Kobayashi Yukiko、Tamura Naoaki、Uchida Toshiyuki、Itoh Hiroaki
    • Journal Title

      International Journal of Women's Dermatology

      Volume: 6 Issue: 3 Pages: 176-181

    • DOI

      10.1016/j.ijwd.2020.02.009

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Comparison of three classification systems of Prepregnancy Body Mass Index with Perinatal Outcomes in Japanese Obese Pregnant Women: A retrospective study at a single center2020

    • Author(s)
      Sugimura Ryo、Kohmura-Kobayashi Yukiko、Narumi Megumi、Furuta-Isomura Naomi、Oda Tomoaki、Tamura Naoaki、Uchida Toshiyuki、Suzuki Kazunao、Sugimura Motoi、Kanayama Naohiro、Itoh Hiroaki
    • Journal Title

      International Journal of Medical Sciences

      Volume: 17 Issue: 13 Pages: 2002-2012

    • DOI

      10.7150/ijms.47076

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Consumptive Coagulopathy Involving Amniotic Fluid Embolism: The Importance of Earlier Assessments for Interventions in Critical Care2020

    • Author(s)
      Oda Tomoaki、Tamura Naoaki、Ide Rui、Itoh Toshiya、Horikoshi Yoshimasa、Matsumoto Masako、Narumi Megumi、Kohmura-Kobayashi Yukiko、Furuta-Isomura Naomi、Yaguchi Chizuko、Uchida Toshiyuki、Suzuki Kazunao、Itoh Hiroaki、Kanayama Naohiro
    • Journal Title

      Critical Care Medicine

      Volume: 48 Issue: 12 Pages: e1251-e1259

    • DOI

      10.1097/ccm.0000000000004665

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Elevated bradykinin receptor type 1 expression in postpartum acute myometritis: Possible involvement in augmented interstitial edema of the atonic gravid uterus2019

    • Author(s)
      Shen Yi、Oda Tomoaki、Tamura Naoaki、Kohmura‐Kobayashi Yukiko、Furuta‐Isomura Naomi、Yaguchi Chizuko、Uchida Toshiyuki、Suzuki Kazunao、Itoh Hiroaki、Kanayama Naohiro
    • Journal Title

      Journal of Obstetrics and Gynaecology Research

      Volume: 45 Issue: 8 Pages: 1553-1561

    • DOI

      10.1111/jog.14012

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Amniotic fluid as a potent activator of blood coagulation and platelet aggregation: Study with rotational thromboelastometry2018

    • Author(s)
      Oda T, Tamura N, Shen Y, Kohmura-Kobayashi Y, Furuta-Isomura N, Yaguchi C, Uchida T, Suzuki K, Itoh H, Kanayama N
    • Journal Title

      Thromb Res

      Volume: 172 Pages: 142-149

    • DOI

      10.1016/j.thromres.2018.11.001

    • Related Report
      2018 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 教育講演:母体安全の提言から、妊産婦死亡の新たな主原因を探る、羊水塞栓症管理指針2019

    • Author(s)
      田村直顕
    • Organizer
      第71回日本産科婦人科学会学術講演会 医会学会共同企画 生涯研修プログラム
    • Related Report
      2019 Research-status Report
    • Invited
  • [Presentation] Acute myometritis in refractory postpartum hemorrhage: - the underlying pathology and the development of novel treatment for uterine-type amniotic fluid embolism-2018

    • Author(s)
      Naoaki Tamura
    • Organizer
      70th Annual Congress of JSOG, 2nd J-K-T Joint Conference, 仙台 2018年5月11日
    • Related Report
      2018 Research-status Report
    • Invited

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Published: 2018-04-23   Modified: 2022-01-27  

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