[The EXIT procedure]

Area of Science:

• Obstetrics and Gynecology
• Fetal Surgery
• Neonatal Care

Background:

• The ex utero intrapartum treatment (EXIT) procedure is a specialized intervention for fetuses facing predictable postpartum airway obstruction.
• Indications include fetal neck tumors, tracheal obstruction, diaphragmatic hiatus hernia, and congenital high airway obstruction syndrome (CHAOS).
• Large cervical tumors pose delivery challenges due to head reclination and potential airway compromise.

Observation:

• A case involving an unborn fetus with a large cervical teratoma was monitored throughout pregnancy using ultrasound and MRI.
• The teratoma was identified as a significant risk for cervical airway obstruction.
• The EXIT procedure was deemed necessary due to the predicted delivery complications.

Findings:

• The EXIT procedure was successfully performed on the fetus with a large cervical teratoma.
• Continuous fetal airway protection was maintained during the procedure.
• The interdisciplinary approach to the EXIT procedure was crucial for its successful execution.

Implications:

• The successful EXIT procedure demonstrates its efficacy in managing complex fetal airway obstructions caused by cervical teratomas.
• This case underscores the importance of advanced imaging and multidisciplinary collaboration in high-risk fetal surgeries.
• The EXIT procedure offers a viable solution for complex deliveries, ensuring fetal survival and minimizing neonatal complications.