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Intravenous and Intra-amniotic In Utero Transplantation in the Murine Model
06:43

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Published on: October 9, 2018

Ex-utero intrapartum therapy.

Kenneth W Liechty1

  • 1Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA. Liechty@email.cho.edu

Seminars in Fetal & Neonatal Medicine
|August 18, 2009
PubMed
Summary
This summary is machine-generated.

The ex-utero intrapartum therapy (EXIT) procedure provides a critical airway intervention for fetuses with complex conditions. It enables life-saving procedures by maintaining fetal-placental circulation during delivery.

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Area of Science:

  • Perinatal Medicine
  • Fetal Surgery
  • Neonatal Airway Management

Background:

  • The ex-utero intrapartum therapy (EXIT) procedure was initially developed for fetuses requiring tracheal occlusion due to severe congenital diaphragmatic hernia.
  • Its application has expanded to manage various fetal anomalies presenting with potential airway compromise or resuscitation challenges.

Purpose of the Study:

  • To describe the evolution and extended applications of the EXIT procedure.
  • To highlight the key principles enabling successful EXIT procedures.

Main Methods:

  • Preservation of uteroplacental blood flow and gas exchange.
  • Use of inhalational agents for uterine relaxation.
  • Maintenance of uterine volume via amnioinfusion and controlled fetal exposure.

Main Results:

  • Facilitates critical interventions such as laryngoscopy, bronchoscopy, vascular access, mass resection, and extracorporeal membrane circulation cannulation.
  • Transforms emergent delivery crises into controlled surgical situations.
  • Successfully manages complex fetal conditions requiring immediate postnatal intervention.

Conclusions:

  • The EXIT procedure is a versatile technique for managing complex fetal airway and resuscitation issues.
  • Its success relies on maintaining maternal-fetal physiological support during the procedure.
  • EXIT offers a vital bridge for neonates requiring complex surgical or medical support immediately after birth.