title: Anesthesia for ex utero intrapartum treatment: renewed insight on a rare procedure.
abstract: The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report.
authors.affiliation: Serviço de Anestesiologia, Hospital Universitário de Santa Maria, Centro Hospitalar de Lisboa Norte, E.P.E., Lisboa, Portugal. Electronic address: miguelvieiramarques@hotmail.com.
authors.forename: Miguel Vieira
authors.initials: MV
authors.lastname: Marques
authors.affiliation: Serviço de Anestesiologia, Hospital Universitário de Santa Maria, Centro Hospitalar de Lisboa Norte, E.P.E., Lisboa, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Carneiro
authors.affiliation: Serviço de Anestesiologia, Hospital Curry Cabral, Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Adriano
authors.affiliation: Serviço de Anestesiologia, Hospital Universitário de Santa Maria, Centro Hospitalar de Lisboa Norte, E.P.E., Lisboa, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Lança
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods*; D000758:Anesthesia / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D006801:Humans; D008202:Lymphangioma / Q000601:surgery*; D011247:Pregnancy
keywords: Airway – obstruction; Anestesia – fetal; Anestesia – obstétrica; Anesthesia – fetal; Anesthesia – obstetric; Cervical lymphangioma; EXIT; Linfangioma cervical; Vias aéreas – obstrução