2006
DOI: 10.1159/000097106
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Evolving Indications for the EXIT Procedure: The Usefulness of Combining Ultrasound and Fetal MRI

Abstract: The EXIT procedure (EX utero Intrapartum Treatment) encompasses a multidisciplinary approach to situations in which airway obstruction is anticipated. Uteroplacental circulation is maintained to avoid neonatal hypoxemia while intubation is attempted. Not only is it useful in congenital diaphragmatic hernia with intrauterine tracheal occlusion, but new indications have been proposed. We present two cases in which EXIT procedure was adopted (huge cervical mass with tracheal compression and a highly vascularized … Show more

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Cited by 30 publications
(23 citation statements)
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“…However, direct visualization of the larynx and trachea and the ability to demonstrate airway patency may be challenging. Nevertheless, ultrasound is still quite suitable for visualizing secondary signs of aerodigestive tract obstruction such as polyhydramnios, the absence of a stomach bubble or to diagnose a decrease in fetal swallowing using color Doppler ultrasound [12] . The use of fetal MRI provides a more comprehensive field of view, and with excellent contrast resolution from T 2 -weighted sequences, a more accurate assessment of airway compression can be made.…”
Section: Discussionmentioning
confidence: 99%
“…However, direct visualization of the larynx and trachea and the ability to demonstrate airway patency may be challenging. Nevertheless, ultrasound is still quite suitable for visualizing secondary signs of aerodigestive tract obstruction such as polyhydramnios, the absence of a stomach bubble or to diagnose a decrease in fetal swallowing using color Doppler ultrasound [12] . The use of fetal MRI provides a more comprehensive field of view, and with excellent contrast resolution from T 2 -weighted sequences, a more accurate assessment of airway compression can be made.…”
Section: Discussionmentioning
confidence: 99%
“…Prenatal therapy of large fetal neck lymphangiomas may include the EXIT procedure [3][4][5] . Well-programmed EXIT delivery in centers with a trained multidisciplinary team is considered a safe procedure.…”
Section: Discussionmentioning
confidence: 99%
“…Magnetic resonance imaging (MRI) is essential in detecting the location of the tumor in relation to adjacent structures and predicting postnatal compressive complications, which is important for planning management options [2] . When airway obstruction is suspected, the EXIT (ex utero intrapartum treatment) procedure is suggested with potential use of intubation or tracheostomy [3][4][5] . As this procedure has substantial risks [3] , the introduction of a safer method for the management of pre-Abstract Lymphangiomas are benign vascular malformations of the lymphatic system and most commonly present in the neck area.…”
Section: Introductionmentioning
confidence: 99%
“…Prenatal assessment of fetal lung lesions is optimized by combining ultrasound findings (LHR, CVR) and fetal magnetic resonance imaging (MRI) findings (lesion volume and lung volume) [17] . The CVR is a measure of the CCAM volume adjusted for gestational age [18] , and may be useful in identifying other high-risk fetal lung lesions.…”
Section: Discussionmentioning
confidence: 99%