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The ex utero intrapartum treatment (EXIT) procedure.
Semin Neonatol. 2003 Jun; 8(3):207-14.SN

Abstract

The ex utero intrapartum treatment (EXIT) procedure was originally developed to reverse temporary tracheal occlusion in patients who had undergone foetal surgery for severe congenital diaphragmatic hernia (CDH). In a select group of foetuses with CDH, tracheal occlusion is used to obstruct the normal flow of foetal lung fluid and to stimulate lung expansion and growth. With the airway obstructed, airway management at birth is critical. The solution was to arrange delivery in such a way that the occlusion could be removed and the airway secured while the baby remained on placental support. If the uterus was kept relaxed and the utero-placental blood flow kept intact, the foetus could remain on a maternal 'heart-lung machine' while the airway was secured. While the technique of tracheal occlusion remains under study in clinical trials, EXIT procedures have been shown to be useful for management of other causes of foetal airway obstruction.

Authors+Show Affiliations

Division of Pediatric Surgery, Fetal Treatment Center, University of California, 513 Parnassus Avenue, HSW 1601, San Francisco, CA 94143-0570, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15001139

Citation

Hirose, Shinjiro, and Michael R. Harrison. "The Ex Utero Intrapartum Treatment (EXIT) Procedure." Seminars in Neonatology : SN, vol. 8, no. 3, 2003, pp. 207-14.
Hirose S, Harrison MR. The ex utero intrapartum treatment (EXIT) procedure. Semin Neonatol. 2003;8(3):207-14.
Hirose, S., & Harrison, M. R. (2003). The ex utero intrapartum treatment (EXIT) procedure. Seminars in Neonatology : SN, 8(3), 207-14.
Hirose S, Harrison MR. The Ex Utero Intrapartum Treatment (EXIT) Procedure. Semin Neonatol. 2003;8(3):207-14. PubMed PMID: 15001139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The ex utero intrapartum treatment (EXIT) procedure. AU - Hirose,Shinjiro, AU - Harrison,Michael R, PY - 2004/3/6/pubmed PY - 2004/3/30/medline PY - 2004/3/6/entrez SP - 207 EP - 14 JF - Seminars in neonatology : SN JO - Semin Neonatol VL - 8 IS - 3 N2 - The ex utero intrapartum treatment (EXIT) procedure was originally developed to reverse temporary tracheal occlusion in patients who had undergone foetal surgery for severe congenital diaphragmatic hernia (CDH). In a select group of foetuses with CDH, tracheal occlusion is used to obstruct the normal flow of foetal lung fluid and to stimulate lung expansion and growth. With the airway obstructed, airway management at birth is critical. The solution was to arrange delivery in such a way that the occlusion could be removed and the airway secured while the baby remained on placental support. If the uterus was kept relaxed and the utero-placental blood flow kept intact, the foetus could remain on a maternal 'heart-lung machine' while the airway was secured. While the technique of tracheal occlusion remains under study in clinical trials, EXIT procedures have been shown to be useful for management of other causes of foetal airway obstruction. SN - 1084-2756 UR - https://www.unboundmedicine.com/medline/citation/15001139/The_ex_utero_intrapartum_treatment__EXIT__procedure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1084275603000290 DB - PRIME DP - Unbound Medicine ER -