Our Experience with EXIT Procedures: A Case Series

Respiratory distress in neonates presents challenges necessitating immediate airway management. This case series explores two instances of Ex-Utero Intra Partum Procedure (EXIT) for newborns with congenital airway obstructions. Case 1 describes a 34-year-old gravida 2 para 1 at 35 + 1 weeks with micrognathia. Due to failed intubation, an EXIT tracheostomy was performed successfully within 18 min, maintaining foetal oxygenation through utero-placental circulation. Case 2 involves a 29-year-old primigravida at 34 + 1 weeks with Congenital High Airway Obstruction Syndrome (CHAOS), where a planned EXIT tracheostomy was executed. These cases highlight the crucial role of multidisciplinary teams comprising obstetricians, anaesthetists, neonatologists, and specialized surgeons. Discussion emphasizes early prenatal diagnosis, meticulous planning, and parental counselling. The EXIT procedure is crucial for various indications such as oropharyngeal masses and CHAOS. Challenges like fetal tissue pliability and maintaining utero-placental circulation are addressed. Early detection, pathology understanding, and thorough planning are vital for successful outcomes. Psychological support for parents and a multidisciplinary approach ensure optimal maternal and neonatal outcomes. This series underscores the significance of the EXIT procedure in managing neonatal airway emergencies, particularly in preterm births.