Evolving indications for the EXIT procedure: the usefulness of combining ultrasound and fetal MRI

Fetal Diagn Ther. 2007;22(2):107-11. doi: 10.1159/000097106. Epub 2006 Nov 27.

Abstract

The EXIT procedure (EX utero Intrapartum Treatment) encompasses a multidisciplinary approach to situations in which airway obstruction is anticipated. Uteroplacental circulation is maintained to avoid neonatal hypoxemia while intubation is attempted. Not only is it useful in congenital diaphragmatic hernia with intrauterine tracheal occlusion, but new indications have been proposed. We present two cases in which EXIT procedure was adopted (huge cervical mass with tracheal compression and a highly vascularized cephalocervical mass) for the same purpose on different grounds. Our two cases stress once more the importance of combining fetal ultrasound and magnetic resonance imaging in the characterization of cervical masses and its usefulness in programming the procedure with a multidisciplinary team.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery*
  • Cesarean Section / methods*
  • Female
  • Fetal Diseases* / diagnosis
  • Fetal Diseases* / surgery
  • Gestational Age
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / surgery
  • Humans
  • Hysterotomy
  • Intubation, Intratracheal / methods
  • Live Birth
  • Lymphangioma, Cystic / complications
  • Lymphangioma, Cystic / diagnosis
  • Lymphangioma, Cystic / surgery
  • Magnetic Resonance Imaging / methods*
  • Nerve Sheath Neoplasms / complications
  • Nerve Sheath Neoplasms / diagnosis
  • Nerve Sheath Neoplasms / surgery
  • Placental Circulation*
  • Pregnancy
  • Ultrasonography, Prenatal / methods*