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Related Experiment Videos

Ex utero intrapartum therapy.

Holly L Hedrick1

  • 1The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Seminars in Pediatric Surgery
|September 10, 2003
PubMed
Summary

Ex utero intrapartum therapy (EXIT) procedures maintain fetal gas exchange during complex surgeries. This technique allows for critical interventions, converting emergencies into controlled situations for improved fetal outcomes.

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Area of Science:

  • Perinatal medicine
  • Fetal surgery
  • Neonatal intensive care

Background:

  • The Ex Utero Intrapartum Therapy (EXIT) procedure is designed to maintain uteroplacental blood flow and gas exchange.
  • This is achieved through specific anesthetic agents, amnioinfusion, and partial fetal delivery.

Purpose of the Study:

  • To evaluate the indications, methods, and outcomes of EXIT procedures performed at a major children's hospital.
  • To assess the utility of EXIT in managing complex fetal conditions requiring immediate intervention.

Main Methods:

  • Retrospective review of 43 EXIT procedures conducted between March 1996 and December 2002.
  • Analysis of indications, interventions performed during EXIT, and immediate outcomes.

Main Results:

  • Common indications included fetal airway obstruction (neck masses, congenital high airway obstruction syndrome) and congenital diaphragmatic hernia (CDH).
  • EXIT facilitated essential procedures like tracheotomy, mass resection, and extracorporeal membrane oxygenation (ECMO) cannulation.
  • One mortality occurred due to inability to secure the fetal airway.

Conclusions:

  • The EXIT procedure is a valuable tool for managing complex fetal anomalies requiring immediate surgical intervention.
  • It effectively provides a controlled environment for critical procedures, optimizing fetal outcomes by utilizing uteroplacental support.

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