Document Detail


Ex-utero intrapartum therapy.
MedLine Citation:
PMID:  19683972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The ex-utero intrapartum therapy (EXIT) procedure was designed to secure the airway at delivery in fetuses who had undergone tracheal occlusion for severe congenital diaphragmatic hernia. The EXIT was then adapted for deliveries where the airway may be difficult to secure, such as large neck masses or congenital high airway obstruction. Subsequently, use of EXIT has been extended to fetal anomalies where resuscitation may be compromised, including large thoracic masses, severe congenital diaphragmatic hernia, or pulmonary agenesis. The key to EXIT is preservation of uteroplacental blood flow and gas exchange, using inhalational agents to provide uterine relaxation, and maintenance of uterine volume by amnioinfusion and only partial exposure of the fetus. This provides time for procedures such as laryngoscopy, bronchoscopy, vascular access, resection of neck or lung masses, or cannulation for extracorporeal membrane circulation, in order to convert an emergent crisis to a controlled situation.
Authors:
Kenneth W Liechty
Publication Detail:
Type:  Journal Article; Review     Date:  2009-08-15
Journal Detail:
Title:  Seminars in fetal & neonatal medicine     Volume:  15     ISSN:  1878-0946     ISO Abbreviation:  Semin Fetal Neonatal Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101240003     Medline TA:  Semin Fetal Neonatal Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009. Published by Elsevier Ltd.
Affiliation:
Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA. Liechty@email.cho.edu
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MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / congenital,  etiology,  surgery,  therapy*
Balloon Dilatation
Cystic Adenomatoid Malformation of Lung, Congenital / therapy
Female
Fetal Diseases / surgery,  therapy*
Head and Neck Neoplasms
Hernia, Diaphragmatic / congenital,  therapy
Humans
Infant, Newborn
Intraoperative Care / methods*
Mediastinal Neoplasms
Organ Size
Placental Circulation
Pregnancy
Prenatal Diagnosis*
Trachea
Tracheostomy
Treatment Outcome
Uterus / anatomy & histology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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