Ex utero intrapartum treatment (EXIT) procedures. Semin Pediatr Surg 2019 Aug;28(4):150820
Date
08/28/2019Pubmed ID
31451172DOI
10.1053/j.sempedsurg.2019.07.003Scopus ID
2-s2.0-85071008623 (requires institutional sign-in at Scopus site) 41 CitationsAbstract
Ex Utero Intrapartum Treatment (EXIT) is a technique developed to safely and efficiently establish cardiopulmonary support at delivery while maintaining placental bypass. Indications for the EXIT approach are expanding and currently include EXIT-to-airway, EXIT-to-resection, EXIT-to-extracorporeal membrane oxygenation (ECMO), and EXIT-to-separation of conjoined twins. The EXIT technique involves planned partial delivery of the fetus via hysterotomy while maintaining uterine relaxation and placental support, allowing for the establishment of neonatal cardiopulmonary stability in a controlled manner. Fetal interventions performed during EXIT can include endotracheal intubation, tracheostomy, mass excision, removal of a temporary tracheal occlusive device, ECMO cannulation, and others. The most important aspect of an EXIT procedure is the formation of a multi-disciplinary team with broad expertise in fetal intervention to collaborate throughout the pre, intra, and post-partum periods. This chapter reviews the prenatal workup, decision making, surgical indications, and operative considerations associated with EXIT procedures.
Author List
Bence CM, Wagner AJAuthors
Christina Bence MD Assistant Professor in the Surgery department at Medical College of WisconsinAmy Wagner MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Airway ObstructionAnesthesia, General
Extracorporeal Membrane Oxygenation
Female
Fetal Diseases
Humans
Hysterotomy
Infant, Newborn
Patient Care Team
Pregnancy
Prenatal Diagnosis
