Use of ex utero intrapartum treatment procedure in fetal neck and high airway anomalies - report of four clinical cases

J Matern Fetal Neonatal Med. 2019 Mar;32(5):870-874. doi: 10.1080/14767058.2017.1390740. Epub 2017 Oct 26.

Abstract

Purpose: To present antenatal management and use of ex utero intrapartum treatment (EXIT) in different fetal neck and high airway anomalies.

Material and methods: We have presented four different cases of fetal neck or airway pathology which were indications for EXIT, at our department.

Results: In three cases of fetal neck tumors, the primary precise antenatal diagnoses of tumors were confirmed after birth. The airways of all three fetuses were properly secured during EXIT by laryngologist. All these newborns survived. In the fourth case, a primary, antenatal diagnosis of congenital high airway obstruction syndrome due to severe trachea obstruction was not confirmed after birth. Finally, due to complete trachea dysgenesis, neither tracheoscopy nor tracheostomy was done during EXIT and the baby died.

Conclusion: Despite a failure of intrapartum treatment in the fourth case, we strongly recommend this procedure for deliveries of fetuses with a suspicion of airway obstruction.

Keywords: intrapartum treatment; Cesarean section; congenital high airway obstruction; fetal neck tumors; trachea.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section*
  • Constriction, Pathologic / diagnostic imaging
  • Female
  • Fetal Diseases / diagnostic imaging*
  • Fetal Diseases / surgery
  • Fetal Therapies*
  • Goiter / diagnostic imaging
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Infant, Newborn
  • Lymphangioma / diagnostic imaging
  • Male
  • Pregnancy
  • Teratoma / diagnostic imaging
  • Trachea / abnormalities
  • Trachea / diagnostic imaging
  • Ultrasonography, Prenatal

Supplementary concepts

  • Tracheal agenesis