Ex-Utero Intrapartum Treatment: Indications, Considerations, and Postnatal Expectations

Ex-utero intrapartum treatment (EXIT) is a complex procedure that allows for surgical placement of a secure airway during delivery for neonates with concern for significant obstructive airway or intrathoracic pathology. The goal of this procedure is to facilitate extrauterine transition to minimize prolonged hypoxia or cardiorespiratory collapse. The EXIT procedure can be categorized to include EXIT to airway, EXIT to resection, EXIT to extracorporeal membrane oxygenation, and EXIT to separation. Extensive multidisciplinary care coordination is needed to minimize morbidity and mortality in the pregnant person and neonate associated with the procedure. In this article, we summarize the indications for the EXIT procedure, describe the specific components of the procedure, and review the outcomes, risks, and complications in affected neonates.