09-10, 07:00–07:30 (Europe/Istanbul), Pediatric Otolaryngology 2
<u>Title:- EXIT [Ex Utero Intrapartum Treatment] procedure</u>
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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
Name of hospital- Rainbow children’s hospitals. Hyderabad, India
NAME: Dr.Murthy Panchala
PRESENT DESIGNATION;- Senior Consultant ENT Surgeon
CURRENT PLACE OF WORK: Star Hospital & Rainbow Children’s Hospital, Hyd
NOTABLE ACHIEVEMENTS AND AWARDS/RESEARCH/ ACADEMICS:
1st prize for best video presentation on “Trans oral Excision of Base tongue lesions in Neonates” at Singapore on 3rd Nov 201 9 at
Singapore general Hospital.
1st prize for Best surgical video “Trans oral repair of Supraglottic stenosis” in MID LVA con [Indo-US Airway Conference ] held on
18,19,20 February 2019.
Awarded Gold medal for Dr.K.U Shah senior consultant award 4 to 7th January AOICON 2024, held at Bangalore, India
Received 4 Gold medals - Sri Poojari Lakshminarayana gold medals category.
AREAS OF INTEREST:
Pediatric Airway disorders, Pediatric Snoring, & Sleep Apnea.
Education:
Graduated from Andhra Medical college in 2001.
Post graduation from Rangaraya Mesical College 2006.
DNB training from IIPMER, Hyderabad,2009.
Life membership in LVA, IASSA, AOI, AOI TS.
Awards Received.
Received Visting doctor fellow certificate from LAUSANNE UNIVERSITY HOSPITAL, Switzerland.
Fellowship certificate from IASSA CTP .
1st prize for best video presentation on “Trans oral Excision of Base tongue lesions in Neonates” at
Singapore on 3rd Nov 2019 at Singapore general Hospital.
1st prize for Best surgical video “Trans oral repair of Supraglottic stenosis” in MID LVA con [Indo-US
Airway Conference ] held on 18,19,20 February 2019.
Awarded Gold medal for Dr.K.U Shah senior consultant award 4 to 7th January AOICON 2024, held
at Bangalore, India
Received 4 Gold medals - Sri Poojari lakshminarauyana gold medals category.
Attended as invited Faculty speaker for various International, National, State level conferences.