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Ex utero intrapartum treatment (EXIT) procedures
Christina M Bence1, Amy J Wagner1
1Children's Hospital of Wisconsin, Medical College of Wisconsin, 999 N. 92nd Street, Suite 320, Milwaukee, WI 53226, USA.
Seminars in Pediatric Surgery
|August 28, 2019
Summary
Ex Utero Intrapartum Treatment (EXIT) provides cardiopulmonary support during delivery for complex fetal conditions. This technique enables crucial fetal interventions before full birth, ensuring neonatal stability.
Area of Science:
- Medical Interventions
- Fetal Surgery
- Neonatal Care
Background:
- Ex Utero Intrapartum Treatment (EXIT) is a specialized delivery technique.
- It allows for cardiopulmonary support and placental bypass during delivery.
- Indications for EXIT are expanding to include various fetal interventions.
Purpose of the Study:
- To review prenatal workup for EXIT procedures.
- To discuss decision-making, surgical indications, and operative considerations.
- To highlight the importance of multidisciplinary teams in EXIT procedures.
Main Methods:
- The EXIT technique involves planned partial fetal delivery via hysterotomy.
- Uterine relaxation and placental support are maintained throughout the procedure.
- Neonatal cardiopulmonary stability is established in a controlled setting.
Main Results:
- Fetal interventions during EXIT can include airway management, mass excision, and ECMO cannulation.
- The procedure facilitates complex fetal surgeries while maintaining placental circulation.
- Successful EXIT procedures rely on meticulous planning and execution.
Conclusions:
- EXIT procedures offer a safe and efficient approach for complex fetal conditions requiring intervention at birth.
- The success of EXIT hinges on a collaborative, multidisciplinary team.
- This technique is vital for improving outcomes in neonates with critical congenital anomalies.
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