PMID: 20640096Jul 20, 2010Paper

Congenital Cervical Teratoma:Anaesthetic Management (The EXIT Procedure).

Indian Journal of Anaesthesia
Ferruh BilginCuneyt Atabek

Abstract

Ex utero intrapartum treatment (EXIT) is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old woman, 70 kg, 160 cm, gravida 2, para 1, was followed because of polyhydramniosis diagnosed at 24 weeks' gestation. During a routine ultrasonographic examination at 35 weeks' gestation, it was noticed that the fetus had a tumoral mass on the anterior neck, the mass had cystic and calcified components and with a size of was 10 x 6 x5 cm. The patient with physical status ASA I, was submitted to caesarean section under general anaesthesia with mechanically controlled ventilation for exutero intrapartum treatment (EXIT). Anaesthesia was induced in rapid sequence with fentanyl propofol and rocuronium and was maintained with isoflurane in 2.5 at 3 % in O and N O (50%). After hysterotomy, fetus was partially released assuring uterus-placental circulation, followed by fetal laryngoscopy and tracheal intubation. The infant was intubated with an uncuffed, size 2.5 endotracheal tube. Excision of the mass was perf...Continue Reading

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