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英語:“Health ministry team proposes registry for clinics offering painless child deliveries”

A health ministry research team on Feb. 12 reached a broad agreement on a proposal to request institutions performing painless child deliveries to register with the ministry, after a series of accidents involving the childbirth method were reported.
The Ministry of Health, Labor and Welfare team headed by Kitasato University Hospital director Nobuya Unno also agreed that information on painless deliveries, such as the number of procedures performed annually at each institution, should be disclosed.
The team is set to request medical institutions to take appropriate measures according to the proposal, while calling on the government to consider ways to collect and analyze information on mishaps involving painless childbirth cases.
The proposal calls for a registry system for institutions that perform no-pain deliveries and the making of a list of such medical facilities. Each institution is encouraged to disclose information including the overall number of deliveries and painless childbirth procedures, as well as how anesthesia is administered and the doctor’s training in anesthesiology. A working group comprising related medical societies will work on the concrete structure of the system.
The ministry team furthermore stated that it would be desirable to have anesthetists or ob-gyn doctors who have training experience in anesthesiology administer anesthetics for painless deliveries. The team also stated that it would be preferable if these doctors had experience of about 100 cases of administering epidural anesthetics, the method used in painless childbirths. The proposal added that each institution should have a system under which the staff can tend the mother for at least half an hour after anesthetics are administered in case of a sudden change in her condition, and also check on the mother regularly after the initial 30 minutes.
In addition, the team presented examples of requirements for facilities operating painless deliveries, including the preparation of operating manuals and the presence of midwives and nurses versed in caring for women in painless deliveries. The team also requested that medical institutions gain written consent after informing the mother of cases of complications accompanying painless deliveries.

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日本語:“無痛分娩 医療機関、登録制に 厚労省研究班「実施数公開を」”

 事故が相次いで報告された麻酔を使う「無痛分娩(ぶんべん)」について、安全対策を検討してきた厚生労働省研究班(代表者・海野信也北里大病院長)は12日、無痛分娩をする医療機関に登録を求め、年間の実施件数などを公開すべきだとする提言を大筋でまとめた。無痛分娩のための麻酔をかけてもいい医師の認定制度を作る議論もあったが、検討課題として先送りされ、実施する施設や医師の望ましい要件を例示することにとどめた。
 今後、各医療機関に提言に沿った対応を求めるほか、国には被害報告を収集・分析する方法の検討を働き掛けていく。
 提言では、実施施設を登録する仕組みを作ってリスト化し、各施設に分娩の全体数と無痛分娩数、麻酔の方法、担当医の麻酔科研修歴などを公開するよう促す。具体的な制度設計は、関連学会で作るワーキンググループで検討する。
 麻酔を担当する医師については、麻酔科の医師か麻酔科での研修実績のある産婦人科医とし、無痛分娩で使われる「硬膜外麻酔」の経験が100症例程度あるのが望ましいとした。麻酔開始後30分は妊婦の急変時に即応できる体制を取り、その後も定期的に観察することも挙げた。
 施設の要件としては、無痛分娩のケアを熟知した助産師や看護師の勤務や、マニュアルの作成を例示。まれに重い合併症が起こることも妊婦に伝えて文書で同意を得ることも求めた。

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