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Ex utero intrapartum treatment procedure in two fetuses with airway obstruction

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초록

The ex utero intrapartum treatment (EXIT) procedure was introduced to reduce fetal hypoxic damage whileestablishing an airway in fetuses with upper and lower airway obstruction. Delivery of the fetal head and shoulderswhile maintaining the uteroplacental circulation offers time to secure the fetal airway. Here, we report two cases ofEXIT procedure for fetal airway obstruction, which were successfully managed with extensive preoperative planningby a professional multidisciplinary team.

Abstract

The ex utero intrapartum treatment (EXIT) procedure was introduced to reduce fetal hypoxic damage whileestablishing an airway in fetuses with upper and lower airway obstruction. Delivery of the fetal head and shoulderswhile maintaining the uteroplacental circulation offers time to secure the fetal airway. Here, we report two cases ofEXIT procedure for fetal airway obstruction, which were successfully managed with extensive preoperative planningby a professional multidisciplinary team.

참고문헌 (12)

  1. Hubbard AM, "Prenatal MRI evaluation of giant neck masses in preparation for the fetal EXIT procedure", Am J Perinatol, 15, pp.253~257 (1998)[DOI]
  2. Mychaliska GB, "Operating on placental support: the ex utero intrapartum treatment procedure", J Pediatr Surg, 32, pp.227~230 (1997)[DOI]
  3. Norris MC, "Anesthesia for perinatal surgery", Am J Perinatol, 6, pp.39~40 (1989)[DOI]
  4. Abraham RJ, "A review of the EXIT (ex utero intrapartum treatment) procedure", J Obstet Gynaecol, 30, pp.1~5 (2010)[DOI]
  5. 박종택, "무하악증이 동반된 태아의 exutero intrapartum treatment (EXIT) 시술 동안의 마취관리 -증례보고-", Korean Journal of Anesthesiology, 49(5), pp.724~729 (2005), 대한마취통증의학회
  6. 박현주, "선천성 태아 경부 미성숙 기형종에서의 EXIT Procedure 1예", 대한이비인후-두경부외과학회지, 51(7), pp.681~685 (2008), 대한이비인후과학회
  7. 이희승, "Anesthetic management of the ex utero intrapartum treatment (EXIT) procedure -A case report-", Korean Journal of Anesthesiology, 59, pp.154~157 (2010), 대한마취통증의학회
  8. 황일선, "분만 중 자궁 외 치료 시술의 보조로 성공적으로 분만한 선천성 혀낭종 1례", Perinatology, 25(1), pp.22~26 (2014), 대한주산의학회
  9. 박훈, "산전에 발견된 거대 제4형 아가미틈새낭에서의 분만 중 자궁 외 치료 시술 1예", 대한이비인후-두경부외과학회지, 58(11), pp.776~780 (2015), 대한이비인후과학회[DOI]
  10. Mota R, "Evolving indications for the EXIT procedure: the usefulness of combining ultrasound and fetal MRI", Fetal Diagn Ther, 22, pp.107~111 (2007)[DOI]
  11. Dighe MK, "EXIT procedure: technique and indications with prenatal imaging parameters for assessment of airway patency", Radiographics, 31, pp.511~526 (2011)[DOI]
  12. Zamora IJ, "Maternal morbidity and reproductive outcomes related to fetal surgery", J Pediatr Surg, 48, pp.951~955 (2013)[DOI]

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