Document Detail


EXIT procedure for fetal neck masses.
MedLine Citation:
PMID:  22498672     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The ex-utero intrapartum treatment (EXIT procedure) can be life-saving for fetuses with large neck masses. Advances in fetal imaging and access to prenatal care have improved the ability to anticipate and plan for the treatment of these fetuses. This review will highlight advances in imaging techniques, modification of anesthesia and case selection for the EXIT procedure. Long-term maternal and fetal outcomes will also be discussed. RECENT FINDINGS: There have been relatively few articles published on this subject in the past 18 months. A better understanding of the effect of inhalational anesthetics on fetal cardiac function and some insight into the pharmacokinetics of narcotics while on uteroplacental support has been gained. Imaging characteristics that may improve patient selection have been proposed. The long-term outcomes of mothers undergoing fetal surgical procedures in general and specifically those undergoing EXIT procedures suggest that the EXIT procedure can be performed with minimal maternal morbidity in skilled hands. Furthermore, long-term neonatal outcomes appear to be improving, but further studies are needed. SUMMARY: The EXIT procedure can be performed safely in a skilled multidisciplinary setting with minimal maternal and fetal morbidity and excellent fetal outcomes. Recent reports have helped further identify which fetuses will benefit from the EXIT procedure.
Authors:
Oluyinka O Olutoye; Olutoyin A Olutoye
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-11
Journal Detail:
Title:  Current opinion in pediatrics     Volume:  -     ISSN:  1531-698X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000850     Medline TA:  Curr Opin Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aTexas Children's Fetal Center, Texas Children's Hospital bDepartment of Surgery cDepartment of Pediatrics dDepartment of Obstetrics & Gynecology eDepartment of Anesthesia, Baylor College of Medicine, Houston, Texas, USA.
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