Fetal Evaluation and Airway Management

Area of Science:

• Neonatal care
• Fetal surgery
• Pediatric airway management

Background:

• Congenital airway obstruction is increasingly diagnosed prenatally.
• Ex utero intrapartum treatment (EXIT) enables planned airway stabilization.
• EXIT utilizes placental support to minimize neonatal compromise.

Purpose of the Study:

• To review current and emerging fetal evaluation methods for airway obstruction.
• To outline indications for ex utero intrapartum treatment.
• To detail the EXIT procedure and required personnel.

Main Methods:

• Prenatal diagnosis of fetal airway obstruction.
• Ex utero intrapartum treatment (EXIT) for airway stabilization.
• Airway access via laryngoscopy, bronchoscopy, or surgical airway.
• Potential resection of obstructing lesions before delivery completion.

Main Results:

• Decreased incidence of hypoxic injury.
• Reduced peripartum demise related to neonatal airway obstruction.
• Successful planned airway stabilization on placental support.

Conclusions:

• Prenatal diagnosis and EXIT procedures have transformed the management of congenital airway obstruction.
• EXIT allows for safer delivery and immediate airway management.
• This approach minimizes risks associated with neonatal airway compromise.