The ex utero intrapartum treatment procedure for a large fetal neck mass in a twin gestation

Background: Large fetal neck masses can make it difficult or impossible to secure airways at birth, with associated risks of hypoxia, brain injury, an d death. Based on a MEDLINE search from 1966 to June 1998, using the keywor ds EXIT procedure, placental support, twins, and neck mass, we report the f irst ex utero intrapartum treatment procedure performed in a twin gestation complicated by a large fetal neck mass. Case: A giant fetal cervical mass was diagnosed in one fetus of a 20-week t win gestation by sonography and magnetic resonance imaging. At 35 weeks' ge station, the ex utero intrapartum treatment procedure was performed success fully for delivery of the normal twin, followed by intrapartum airway acces s of the twin with the neck mass. Conclusion: Even in twin gestations, the ex utero intrapartum treatment pro cedure is the delivery method of choice for fetuses with giant neck masses. (Obstet Gynecol 1999;93: 824-5. (C) 1999 by The American College of Obstet ricians and Gynecologists.).