EXIT procedure in a twin gestation and review of the literature

Citation
P. Midrio et al., EXIT procedure in a twin gestation and review of the literature, AM J PERIN, 18(7), 2001, pp. 357-362
Citations number
19
Categorie Soggetti
Reproductive Medicine
Journal title
AMERICAN JOURNAL OF PERINATOLOGY
ISSN journal
07351631 → ACNP
Volume
18
Issue
7
Year of publication
2001
Pages
357 - 362
Database
ISI
SICI code
0735-1631(200111)18:7<357:EPIATG>2.0.ZU;2-0
Abstract
Prenatal diagnosis can show masses of the fetal neck, mouth, and face that can potentially cause respiratory distress at birth. To prevent such an eme rgency, the EXIT (ex utero intrapartum technique) is performed: it is the i ntrapartum intubation of the fetus at term while still connected to the pla centa. The EXIT procedure was first performed in a case of cervical teratom a. Up to now a total of 34 cases are described, mostly cervical teratomas ( 13 cases), lymphangiomas (7), epignathus (3); babies' outcome has been succ essful in 25 of them, with one death related to the procedure. Among the re ported cases we are aware of only one where EXIT was performed in a twin ge station, in which the normal twin was delivered first. In our case the norm al fetus was posterior to the twin with cervical malformation, requiring us to work on the latter while the former was still in the uterus. After havi ng safely secured the airway in twin A, twin B was prompt delivered with ex cellent general conditions. Our limited experience enlarges the possibility to perform this prenatal procedure even in "nonstandard" conditions, such as a twin gestation, and may prove useful to those who are going to deal wi th such issues.