Ex Utero intrapartum treatment (EXIT)
نویسندگان
چکیده
The anesthesia ex utero intrapartum treatment (EXIT) procedure is a specialized surgical procedure used to deliver babies who have airway compression due to cystic adenomatoid malformation, bronchopulmonary sequestration, cervical teratomas, or other congenital conditions. EXIT is erroneously known as a routine cesarean section (CS), but is rather an extension of CS with discernible differences. The procedure creates an opening in the anesthetized abdomen of the mother and uterus. Once EXIT is complete, the remainder of the CS proceeds. EXIT is much more complex than a routine CS, as it requires coordination between the mother and a multidisciplinary team of surgical and neonatal personnel. This review highlights current anesthetic concepts during the EXIT procedure.
منابع مشابه
Ex utero intrapartum treatment (EXIT) of severe fetal hydrothorax.
Ex utero intrapartum treatment (EXIT) of a fetus with severe bilateral hydrothorax is described. EXIT allows therapeutic interventions on the neonate while maintaining fetoplacental circulation. Thus it may be useful for fetuses presenting with severe pleural effusion towards the end of gestation and in whom in utero drainage is technically not possible or available and drainage post partum wou...
متن کاملThe use of remifentanil in ex utero intrapartum treatment procedures
Purpose: We propose that using remifentanil in ex utero intrapartum treatment (EXIT) procedures reduces the need for maternal exposure to general anesthesia. Using remifentanil along with spinal anesthesia eliminates the fetal and maternal risks associated with inhalational general anesthesia, allows the mother to be awake, and obviates the need for and costs associated with general anesthesia ...
متن کاملThe use of potent inhalational agents for the ex- utero intrapartum treatment (exit) procedures: what concentrations?
The anesthetic management of a parturient undergoing ex-utero intrapartum treatment (EXIT) procedures for airway control of a newborn with a potentially life-threatening difficult airway is complex and often challenging. We herein report on the successful anesthetic management of the EXIT procedure in a 30-year-old primigravida carrying a fetus with large cervical lymphangioma. General anesthes...
متن کاملFour cases of the ex utero intrapartum treatment (EXIT) procedure: anesthetic implications.
The ex utero intrapartum treatment (EXIT) procedure is a method of maintaining utero-placental circulation during cesarean section to gain time to secure a potentially obstructed fetal airway. Four cases of the EXIT procedure are described with special reference to the maternal anesthetic technique. Deep volatile anesthesia (approximately 2 MAC) with isoflurane or sevoflurane for a prolonged pe...
متن کاملEx Utero Intrapartum Treatment for Fetal Oropharyngeal Cyst
Background. A prenatally diagnosed fetal anomaly that could compromise the fetal airway at delivery can be managed safely with the ex utero intrapartum treatment (EXIT) procedure. Case. A 26-year-old healthy primigravida was diagnosed during her midtrimester anatomic ultrasound survey with a fetal oropharyngeal cystic structure located at the base of the tongue. The neonatal airway was successf...
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