title: An interventional airway delivery service for congenital high airway obstruction.
abstract: BACKGROUND
  Congenital airway obstruction is rare but potentially fatal. We developed a complex airways interventional delivery team to manage such cases. Antenatal imaging detects airway compromise at an early stage and facilitates the planning of delivery procedures ('ex utero intrapartum treatment' and 'operation on placental support') which maintain feto-placental circulation whilst an airway is secured.
  
  
  METHODS
  A retrospective review was performed of cases in which ENT input was required at birth for airway obstruction.
  
  
  RESULTS
  Four neonates were delivered before implementation of the service: two were intubated and another two underwent tracheostomy but died in the peri-natal period. Seven neonates were delivered after implementation of the service: six were intubated and one underwent immediate tracheostomy. Five subsequently underwent tracheostomy (three have since been decannulated). One child with multiple congenital anomalies died due to respiratory failure. Airway obstruction was caused by lymphatic malformation, teratoma, costo-craniomandibular syndrome and choristoma.
  
  
  CONCLUSIONS
  In the absence of other anomalies, interventional airway delivery led to reduced mortality and improved outcomes.
authors.affiliation: Department of Paediatric Otolaryngology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: M M C
authors.initials: MM
authors.lastname: Yaneza
authors.affiliation: Ian Donald Fetal Medicine Unit,The Southern General Hospital,Glasgow,UK.
authors.forename: A
authors.initials: A
authors.lastname: Cameron
authors.affiliation: Department of Paediatric Otolaryngology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: W A
authors.initials: WA
authors.lastname: Clement
authors.affiliation: Department of Paediatric Anaesthetics,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: R
authors.initials: R
authors.lastname: Fairgrieve
authors.affiliation: Ian Donald Fetal Medicine Unit,The Southern General Hospital,Glasgow,UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Ledingham
authors.affiliation: Department of Paediatric Otolaryngology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: M S
authors.initials: MS
authors.lastname: Morrissey
authors.affiliation: Department of Neonatology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: J
authors.initials: J
authors.lastname: Simpson
authors.affiliation: Department of Paediatric Otolaryngology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Wynne
authors.affiliation: Department of Paediatric Otolaryngology,The Royal Hospital for Sick Children,Yorkhill,Glasgow,UK.
authors.forename: H
authors.initials: H
authors.lastname: Kubba
mesh_terms: D000402:Airway Obstruction / Q000151:congenital* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003299:Cooperative Behavior; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D007442:Intubation, Intratracheal; D008279:Magnetic Resonance Imaging; D008297:Male; D010348:Patient Care Team; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012606:Scotland; D015996:Survival Rate; D014139:Tracheostomy; D016896:Treatment Outcome
keywords: Airway Obstruction; Caesarean section; Obstetrics; Otolaryngology; Perinatal Care; Polyhydramnios