EXIT (ex utero intrapartum treatment) surgery for the management of fetal airway obstruction: A systematic review of the literature

Journal of Pediatric Surgery
Rommy H NovoaWalter Ventura

Abstract

To provide a comprehensive overview of the perinatal and maternal outcomes of fetuses undergoing EXIT surgery for the management of fetal airway obstruction secondary to cervical or oral tumors. A comprehensive search from inception to September 2018 was conducted on databases including MEDLINE, EMBASE, Cochrane Library and LILACS. All studies that reported an EXIT surgery in singleton were considered eligible. A descriptive analysis was performed. Out of the 250 full-text study reports, 120 articles reporting 235 cases of EXIT surgery were included. EXIT surgery was performed at 35.1 weeks of gestation on average. The most frequent diagnosis was teratoma (46.4%, n = 109/235). There were 13 adverse maternal events, and the most frequent one was postpartum hemorrhage (4.7%, n = 11/235). No maternal death was reported. Fetal and neonatal death occurred in 17% (40/235) of the cases. There were 29 adverse fetal events (12.2%), and the most frequent one was the failure of intubation or tracheostomy (3.4%, n = 8/235). EXIT surgery could be considered for the management of an oral or cervical tumor that's highly suspicious of blocking the fetal airway. This systematic review reports that EXIT surgery poses substantial risks of materna...Continue Reading

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Citations

Sep 7, 2020·International Journal of Pediatric Otorhinolaryngology·Michael D PuricelliRichard J H Smith
Mar 9, 2021·Anaesthesia·J R DickR Nandi
Jun 12, 2021·Clinical Radiology·G MasselliR Brunelli
Jun 27, 2021·Seminars in Pediatric Surgery·Maria Florencia VarelaJose L Peiro
Oct 13, 2021·Journal of Gynecology Obstetrics and Human Reproduction·Andrew SpiersRomain Corroenne

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