Before surgery, 6 of the 12 children showed normal VEMPs, 1 showed a decrease in the amplitude of VEMPs and five showed no VEMP response. After surgery, with the cochlear implant device off, 1 child showed a decreased VEMP and 11 showed no VEMPs. With the cochlear implant device on, four children showed VEMPs and eight did not.

ObjectiveTo clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems.DesignDescriptive study.SettingMaternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG).ParticipantsWomen who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213).Main outcome measuresThe preventability and problems in each maternal death.ResultsMaternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1–3 h.ConclusionsA range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.

This descriptive study was based on the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and the Maternal Death Exploratory Committee (JMDEC). 361 women died during pregnancy or within 42 days after delivery between January 2010 and June 2017 throughout Japan were analysed, in order to investigate the trend in maternal deaths related to obstetric medical practice. Reports of maternal death were consistent, ranging from 45 cases in 2010 to 44 cases in 2017. Among all maternal deaths, the frequency of deaths due to obstetric haemorrhage ranged from 29% (2010) to 7% (2017) (p < 0.001). The causes of obstetric haemorrhage have progressively reduced, especially maternal deaths due to uterine inversion and laceration have not occurred since 2014. The remaining causes of obstetric haemorrhage-related maternal deaths were placenta accreta spectrum, placental abruption, and severe forms of uterine focused amniotic fluid embolism. We believe the activities of the JMDEC including annual recommendations and simulation programs are improving the medical practices of obstetric care providers in Japan, resulting in a reduction of maternal deaths due to obstetric haemorrhage.

Our results suggest that confirmation of the placental cord insertion, including not only velamentous cord insertion but also the cords located on the lower uterine segment, is the best way to detect vasa previa.

CRH, PLAC1, and selectin-P are distributed differently in preeclampsia cases compared to controls and correlate with signs of preeclampsia.