Management of fetal airway obstruction: an innovative strategy.
This article describes a planned ex utero intrapartum treatment (EXIT) procedure at the Children's Hospital of Philadelphia for a fetus with an airway obstruction resulting from a giant neck mass. The EXIT procedure is a technique that establishes a fetal airway while the utero-placental circulation is maintained for up to 1 hour. As a part of the planned EXIT procedure, a multidisciplinary, highly skilled team was developed to care for both mother and baby. This team consisted of obstetric and surgical personnel to care for the mother during the procedure, the birth, and the recovery, and a neonatal surgical team to care for the newborn. Nursing expertise necessary to conduct this procedure and safely care for the woman and fetus are discussed.
The Center for Fetal Diagnosis and Treatment, Children's Surgical Associates, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA. howelll@email.chop.edu
Lori J
LJ
Howell
Kelli M
KM
Burns
Evelyn
E
Lenghetti
Joy C
JC
Kerr
Lynn Sargent
LS
Harkins
D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000196:embryology / Q000451:nursing / Q000473:pathology / Q000601:surgery*; D002585:Cesarean Section / Q000379:methods* / Q000451:nursing*; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000196:embryology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009773:Obstetric Nursing; D006831:Polyhydramnios / Q000000981:diagnostic imaging; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D013724:Teratoma / Q000000981:diagnostic imaging / Q000196:embryology / Q000601:surgery*; D016216:Ultrasonography, Prenatal