Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies.

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Research Abstract Details 

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Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Abstract Text:

R Zimmermann,

The ex utero intrapartum treatment (EXIT) procedure is designed to guarantee sufficient oxygenation for a foetus at risk of airway obstruction. This is achieved by improving lung ventilation, usually by establishing an airway during caesarean delivery whilst preserving the foetal-placental circulation temporarily. Indications for the EXIT procedure have extended from its original use in reversing iatrogenic tracheal obstruction in congenital diaphragmatic hernia to naturally occurring upper airway obstructions. We report our experience with a new and rarely mentioned indication for the EXIT procedure, intra-thoracic volume expansions. The elaboration of lowest risk scenarios through balancing risks with alternative options, foetal or neonatal intervention and coordination between professionals from various disciplines are the most important conditions for a successful EXIT procedure. The EXIT procedure requires a caesarean section that specifically differs from the traditional caesarean section during which uterine tone is maintained to minimize maternal bleeding. To guarantee foetal oxygenation during the EXIT procedure, profound uterine relaxation is desired. To gain time with optimal placental oxygenation in order to safely perform an airway intervention in a baby at risk of hypoxia may require deep inhalation anaesthesia and/or tocolytic agents. We review the EXIT procedure and present a case series from the University Hospital of Geneva that contrasts with the common indication for the EXIT procedure usually based on upper airway obstruction by its exclusive indication for intra-thoracic malformations/diseases.

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Publishing Authors By Initials

R Zimmermann,

For similar reproductive and urinary physiology: reproduction: pregnancy: labor, obstetric: uterine contraction research abstracts see: reproductive and urinary physiology: reproduction: pregnancy: labor, obstetric: uterine contraction research

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Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Journal Published:

PUBLICATION TYPE: Review

Journal: Swiss medical weekly : official journal of the Swi

VOLUME: 137

Page Numbers: 279-85

Journal Abbreviation:

ISSN: 1424-7860

DAY: 19

MONTH: May

YEAR: 2007

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Information

Number of References: 33

LANGUAGE: eng

NlmUniqueID: 100970884

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies. Keywords Mesh Terms:

KEYWORDS: Uterine Contraction

MESH TERMS: drug effects

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Grant and Affiliation Information for Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies.

AFFILIATION: Anaesthesia, University Hospital Geneva, Switzerland.

Country: Switzerland

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MEDLINETA: Swiss Med Wkly

REFSOURCE: Swiss Med Wkly. 2007 May 19;137(19-20):2

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