EXIT procedure
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The EXIT procedure, or ex utero intrapartum treatment procedure, is a specialized surgical delivery procedure used to deliver babies who have airway compression[1] due to bronchopulmonary sequestration, congenital cystic adenomatoid malformation, cervical teratoma, or other congenital disorder.
Process
The EXIT is an extension of a standard classical Caesarean section, where an opening is made on the midline of the anesthetized mother's abdomen and uterus. Then comes the EXIT: the baby is partially delivered through the opening but remains attached by its umbilical cord to the placenta, while a pediatric or neonatal general surgeon establishes an airway so the fetus can breathe. Once the EXIT is complete, the umbilical cord is cut and clamped, and the infant is fully delivered. Then the remainder of the C-section proceeds.
Challenges
The EXIT is much more complex than a standard C-section, as it requires careful coordination between the mother's physicians and the specialists operating on the newborn baby. The difficulty lies in preserving enough blood flow through the umbilical cord, protecting the placenta, and avoiding contractions of the uterus so that there is sufficient time to establish the airway.
References
- Bouchard S, Johnson MP, Flake AW, et al (2002). "The EXIT procedure: experience and outcome in 31 cases". J. Pediatr. Surg. 37 (3): 418–26. PMID 11877660.
See also
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
