title: Annual Report of the Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2015: Proposal of urgent measures to reduce maternal deaths.
abstract: Perinatal care in Japan has progressed rapidly in recent decades, remarkably reducing maternal, perinatal and neonatal mortality rates. This is attributable not only to the sustained efforts and dedication of past obstetricians and midwives, but also to the collective results achieved by the Japan Society of Obstetrics and Gynecology and healthcare administration, including research on advanced medical care, education, medical care improvements and establishing perinatal care centers. Although the maternal mortality rate was in steady decline until 2007 (3.1/100 000 births), it repeatedly fluctuated thereafter, plateauing at 3.4 per 100 000 births in 2013 and 2.7 per 100 000 births in 2014. Thus, the Perinatology Committee has analyzed the current situation of maternal deaths and has proposed countermeasures to reduce such death. The items deliberated upon by related subcommittees in 2015 are presented herein. The addition of indications for 'fibrinogen concentrate', 'eptacog alfa' and approval of the PGE2 vaginal tablet for cervical ripening were discussed in the subcommittee for unapproved drug review. Thus, a request for approval for health insurance coverage was submitted to the 'Evaluation committee on unapproved or off-label drugs with high medical needs' of the Ministry of Health, Labour and Welfare. Maternal and late-maternal deaths from suicide during the 10 years from 2005 to 2014 in Tokyo's 23 wards were jointly examined with the Tokyo Medical Examiner's Office. The suicide rate in the 23 wards is very high, at 8.7 per 100 000 births. Thus, the subcommittee for the reduction of maternal death discussed countermeasures for the eradication of maternal death and maternal suicide and the revision of death certificates.
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeda
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Collaborators, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takeda
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Collaborators, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|Shirota Obstetrical and Gynecological Hospital, Kanagawa, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, University of Tsukuba, Ibaraki, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hamada
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|CTD inc., Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Makino
authors.affiliation: Subcommittee for Unapproved Drug Review, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itoh
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Kumamoto University, Kumamoto, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohba
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Naruse
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, University of Miyazaki, Miyazaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sameshima
authors.affiliation: Subcommittee for the Reduction of Maternal Deaths, Juntendo University, Tokyo, Japan.|Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D020070:Cervical Ripening / Q000187:drug effects; D015232:Dinoprostone / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D063130:Maternal Death / Q000517:prevention & control* / Q000706:statistics & numerical data; D008428:Maternal Mortality; D018743:Perinatal Care / Q000379:methods*; D010500:Perinatology; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use; D000092864:Suicide Prevention
chemical_list: D011994:Recombinant Proteins; D005340:Fibrinogen; C103587:recombinant FVIIa; D015942:Factor VIIa; D015232:Dinoprostone