title: [The EXIT procedure].
abstract: The ex utero intrapartum treatment (EXIT) procedure is used for unborn fetuses in cases of predictable complications of postpartum airway obstruction. Indications for the EXIT procedure are fetal neck tumors, obstruction of the trachea, hiatus hernia of the diaphragm and congenital high airway obstruction syndrome (CHAOS). Large cervical tumors prevent normal delivery of a fetus due to reclination of the head with airway obstruction. Therefore, a primary caesarean section or the EXIT procedure has to be considered. The EXIT procedure has time limitations as the blood supply by the placenta only lasts for 30-60 min. Airway protection has to be ensured during parturition.This article reports the case of an unborn fetus with a large cervical teratoma where an obstruction of the cervical airway was detected and monitored by ultrasound and magnetic resonance imaging (MRI) during pregnancy. The EXIT procedure was therefore used and successfully accomplished. The features of the interdisciplinary aspects of the EXIT procedure are described with the special aspects of each medical discipline.
authors.affiliation: Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie und Kommunikationsstörungen, HELIOS Hörzentrum Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin-Buch, Deutschland. sina.lehmann@helios-kliniken.de
authors.forename: S
authors.initials: S
authors.lastname: Lehmann
authors.forename: A
authors.initials: A
authors.lastname: Blödow
authors.forename: W
authors.initials: W
authors.lastname: Flügel
authors.forename: H
authors.initials: H
authors.lastname: Renner-Lützkendorf
authors.forename: A
authors.initials: A
authors.lastname: Isbruch
authors.forename: F
authors.initials: F
authors.lastname: Siegling
authors.forename: M
authors.initials: M
authors.lastname: Untch
authors.forename: J
authors.initials: J
authors.lastname: Strauß
authors.forename: M B
authors.initials: MB
authors.lastname: Bloching
mesh_terms: D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D011296:Prenatal Diagnosis / Q000379:methods*; D013724:Teratoma / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome