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, and death. Based on a MEDLINE search from 1966 to June 1998, using the keywords EXIT procedure, placental support, twins, and neck mass, we report the first ex utero intrapartum treatment procedure performed in a twin gestation complicated by a large fetal neck mass.


METHODS
A giant fetal cervical mass was diagnosed in one fetus of a 20-week twin gestation by sonography and magnetic resonance imaging. At 35 weeks' gestation, the ex utero intrapartum treatment procedure was performed successfully for delivery of the normal twin, followed by intrapartum airway access of the twin with the neck mass.


CONCLUSIONS
Even in twin gestations, the ex utero intrapartum treatment procedure is the delivery method of choice for fetuses with giant neck masses.
The Center for Fetal Diagnosis and Treatment, The Department of Surgery, The Children's Hospital of Philadelphia, the University of Pennsylvania School of Medicine, 19104, USA.
K W
KW
Liechty
T M
TM
Crombleholme
S
S
Weiner
B
B
Bernick
A W
AW
Flake
N S
NS
Adzick
D000328:Adult; D002585:Cesarean Section / Q000379:methods; D004200:Diseases in Twins; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008202:Lymphangioma / Q000601:surgery*; D008297:Male; D007744:Obstetric Labor Complications / Q000601:surgery*; D011247:Pregnancy; D011296:Prenatal Diagnosis