RT Journal Article
T1 Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses.
A1 Garcia-Diaz, Lutgardo
A1 Chimenea, Angel
A1 de Agustin, Juan Carlos
A1 Pavon, Antonio
A1 Antiñolo, Guillermo
K1 Airway management
K1 Ex-Utero Intrapartum treatment (EXIT)
K1 Fetal airway
K1 Fetal surgery
K1 Neck mass
K1 Placental support
AB The "Ex-Utero Intrapartum Treatment" (EXIT) procedure allows to ensure fetal airway before completion of delivery and umbilical cord clamping while keeping uteroplacental circulation. Airway obstruction in fetal oropharyngeal and cervical masses can be life-threatening at birth. In those situations, controlled access to fetal airway performed by a trained multidisciplinary team allows safe airway management, while feto-maternal circulation is preserved. We aim to review the indications and outcome of the EXIT procedure in a case series of fetal cervical and oropharyngeal masses. We have carried out a retrospective review of all patients with fetal cervical and oropharyngeal masses who underwent an EXIT procedure between 2008 and 2019. Variables evaluated included indication for EXIT, ultrasound and MRI findings, the need of amnioreduction, gestational age at EXIT, birth weight, complications, operative time, survival rate, pathological findings, and postnatal evolution. Five patients are included in this series. One additional case has already been published. The diagnosis were cervical teratoma (n = 1), epulis (n = 1) and lymphangioma (n = 3). Polyhydramnios was present in 2 patients, requiring amnioreduction in one of them. Mean gestational age at EXIT was 36-37 weeks (range, 34-38 weeks). Median EXIT time in placental support was 9 min (range, 3-22 min). Access to airway was successfully established in EXIT in all cases. All children born by EXIT are currently healthy and without complications. The localization and characteristics of the mass, its relationship to the airway, and the presence of polyhydramnios seem to be major factors determining indications for EXIT and clinical outcome.
PB BioMed Central Ltd.
YR 2020
FD 2020-09-30
LK http://hdl.handle.net/10668/16378
UL http://hdl.handle.net/10668/16378
LA en
NO García-Díaz L, Chimenea A, de Agustín JC, Pavón A, Antiñolo G. Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses. BMC Pregnancy Childbirth. 2020 Oct 7;20(1):598
NO All persons that contributed to this study are listed authors and meet thecriteria for authorship.
DS RISalud
RD Apr 7, 2025