Published May 7, 2020



PLUMX
Almetrics
 
Dimensions
 

Google Scholar
 
Search GoogleScholar


Ana María Acosta Rodríguez

Carolina Mateus https://orcid.org/0000-0001-7946-7671

María Baquero https://orcid.org/0000-0003-4732-6529

Paola Gómez

Juan Lalinde https://orcid.org/0000-0001-8704-3684

Rodolfo Martínez https://orcid.org/0000-0002-2498-1478

Angélica Fajardo https://orcid.org/0000-0003-2166-9048

Juan Camilo Ospina García https://orcid.org/0000-0001-7806-5355

##plugins.themes.bootstrap3.article.details##

Abstract

The present article is the report of the first Ex Utero Intrapartum procedure (EXIT), carried out at the San Ignacio University Hospital, by an interdisciplinary group (anesthesiologist, pediatric otolaryngologist, neonatologist and obstetrician).


The need for an EXIT strategy is rare. Its objective is to secure the newborn's airway during childbirth when there is a risk of airway obstruction, that may be caused by secondary compression from cervical or mediastinal masses, congenital craniofacial or airway malformations. The aim of the surgery is to reduce the risk of mortality of the newborn.


 We present a 33 years old patient with a gestational age of 38 weeks and a diagnosis of cervical cystic lesion in the fetus by gestational week 25.


The delivery was performed by securing the neonate’s airway with orotracheal intubation. In this case, a vascular macrocystic lymphatic malformation was confirmed.


 The objective of the article is to emphasize that proper planning and prenatal diagnosis of cervical malformations significantly improves the patient's prognosis, both in the short and the long term results.

Keywords
References
Referencias

1. Dighe MK, Peterson SE, Dubinsky TJ, Perkins J, Cheng E. EXIT procedure: technique and indications with prenatal imaging parameters for assessment of airway patency. Radiographics. 2011;31(2):511-26. http://doi.org/10.1148/rg.312105108

2. Garcia P, Olutoye OO, Ivey RT, Olutoye OA. Case scenario: anesthesia for maternal-fetal surgery. The ex utero intrapartum therapy (EXIT) procedure. Anesthesiology. 2011;114(6):1446-52.

3. Oliveira E, Pereira P, Retroz C, Mártires E. Anesthesia for EXIT procedure (ex utero intrapartum treatment) in congenital cervical malformation-a challenge to the anesthesiologist. Braz J Anesthesiol. 2015;65(6):529-33.

4. Sviggum HP, Kodali BS. Maternal anesthesia for fetal surgery. Clin Perinatol. 2013;40(3):413-27.

5. Marwan A, Crombleholme TM. The EXIT procedure: principles, pitfalls, and progress. Semin Pediatr Surg. 2006;15(2):107-15.

6. George RB, Melnick AH, Rose EC, Habib AS. Case series: Combined spinal epidural anesthesia for Cesarean delivery and ex utero intrapartum treatment procedure. Can J Anesth. 2007;54(3):218-22.

7. Laje P, Johnson MP, Howell LJ, Bebbington MW, Hedrick HL, Flake AW, et al. Ex utero intrapartum treatment in the management of giant cervical teratomas. J Pediatr Surg. 2012;47(6):1208-16. https://doi.org/10.1016/j.jpedsurg.2012.03.027

8. Hedrick HL. Ex utero intrapartum therapy. Semin Pediatr Surg. 2003;10:190-5.

9. Hubbard AM, Crombleholme TM, Adzick NS. Prenatal MRI evaluation of giant neck masses in preparation for the fetal EXIT procedure. Am J Perinatol. 1998;15:253-7.

10. Cox J, Barlett E, Lee EI. Vascular malformations: a review. Semin Plast Surg. 2014;28(2):25-63.

11. Gresham TR, Friedman AB. Hemangiomas and vascular malformations: current theory and management. Int J Pediatr. 2012:645678. https://doi.org/10.1155/2012/645678

12. Ospina J, Wuesthoff C, Eslava S. EXIT: tratamiento exútero intraparto. Reporte de caso y revisión de la literatura. Rev Colomb Obstet Ginecol. 2012;63(2):155-62.
How to Cite
Acosta Rodríguez, A. M., Mateus, C., Baquero, M., Gómez, P., Lalinde, J., Martínez, R., Fajardo, A., & Ospina García, J. C. (2020). First EXIT (exuterus intapartum treatment) in San Ignacio University Hospital: Case Report: Reporte de caso. Universitas Medica, 61(3). https://doi.org/10.11144/Javeriana.umed61-3.exit
Section
Case Reports

Most read articles by the same author(s)