Murthy Panchala
Session
Title:- EXIT [Ex Utero Intrapartum Treatment] procedure
The EXIT procedure is defined as a procedure performed after partial externalization of the fetus from the uterine cavity, while maintaining uterine volume and fetoplacental circulation, ensuring the fetal oxygenation during airway access. Once adequate airway and ventilation are secured, the fetus can be safely taken off placental support.
The EXIT procedure guarantees the uteroplacental gas exchange achieving hemodynamic stability under severe conditions of airway compression in the fetus, therefore, maximizing the chances of neonatal survival. It is an innovative and promising technique in the initial approach to multiple neonatal pathologies.
The indications for EXIT procedure include various conditions associated with possible fetal airway obstruction such as congenital high airway obstruction syndrome (CHAOS) and giant neck masses arising around the upper airway are at high risk for hypoxic brain injury and death at birth. The ex utero intrapartum treatment (EXIT) procedure is a technique that can provide time to manage the fetal airway by intubation or tracheostomy while maintaining placental blood circulation to the fetus.
Antenatal History reveals, Precious pregnancy G7 P0 L0 A6. Prenatal anomaly scan shows neck mass. We planned elective caesarian section 1week prior to EDD. Expert Team include Gynecologist, Fetal medicine expert, Anesthesiologist, Pead Surgeon, Pead ENT Surgeon, Neonatologist, OT Staff, and Technicians. we all had multiple prior meetings and practiced simulation of the EXIT procedure, allocated the timing, and role of each speciality. Finally Succeded the EXIT.
The successful outcome of an EXIT procedure depends upon thorough and accurate prenatal investigations like imaging, including fetal ultrasonography and fetal magnetic resonance imaging (MRI) have led to changes in perinatal management and improved neonatal outcomes appropriate presurgical planning, and the availability of a highly skilled multidisciplinary team and facilities like NICU.
Name of the Participant-Dr.Panchala Murthy
Address- Rainbow children’s hospitals
[email protected]
Name of hospital- Rainbow children’s hospitals. Hyderabad, India