1998
DOI: 10.1159/000020852
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Prenatally Diagnosed Fetal Neck Teratoma

Abstract: A case of fetal neck teratoma diagnosed at 32 weeks’ gestation is reported. Planning before delivery included consultations with the neonatologist, the anesthesiologist, the otolaryngologist and the social worker. Delivery by cesarean section under epidural anesthesia was carried out at 34 weeks because of preterm labor. The head was delivered and the fetus was intubated within 4½ min using a rigid bronchoscope. Magnesium sulfate and nitroglycerin provided uterine relaxation allowing fetal oxygenation via the … Show more

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Cited by 27 publications
(12 citation statements)
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“…They successfully used epidural anesthesia with IV nitroglycerin (NTG) to achieve adequate surgical conditions. Subsequently, five other reports of RA have been published[ 14 15 16 17 18 ] involving 9 patients [ Figure 2 ]. Eight patients received a combined spinal-epidural (CSE) anesthetic with bupivacaine in doses ranging from 10 to 12 mg and intrathecal fentanyl and epimorphine in doses of 15–25 mcg and 150–300 mcg, respectively.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…They successfully used epidural anesthesia with IV nitroglycerin (NTG) to achieve adequate surgical conditions. Subsequently, five other reports of RA have been published[ 14 15 16 17 18 ] involving 9 patients [ Figure 2 ]. Eight patients received a combined spinal-epidural (CSE) anesthetic with bupivacaine in doses ranging from 10 to 12 mg and intrathecal fentanyl and epimorphine in doses of 15–25 mcg and 150–300 mcg, respectively.…”
Section: Resultsmentioning
confidence: 99%
“…NTG IV was the uterine relaxant of choice in all RA and TIVA[ 10 11 12 14 15 16 17 18 19 ] cases; it was required as an adjunct to inhalational agents in 25 cases. [ 1 5 8 20 22 23 ]…”
Section: Resultsmentioning
confidence: 99%
“…The total surgical bleeding was within the limits of an ordinary Cesarean section and there were no postoperative bleeding problems. The use of magnesium sulfate and nitroglycerin to provide uterine relaxation in an EXIT procedure performed under epidural anesthesia has recently been reported (10). Possible advantages are that the risk for prolonged uterine atony might be decreased and that the mother is awake during surgery.…”
Section: Discussionmentioning
confidence: 99%
“…Since 1989, 29 EXIT‐procedures for large airway comprising embryonic tumors have been reported in literature. The tumors comprised 17 teratomas,38–48 6 cystic hygromas,36, 49–52 2 hemangiomas,38, 41 2 lymphangiomas,39 1 third branchial cleft,43 and 1 epulis (gingival granular cell tumor) 43. Endotracheal intubation was successful in 17 cases, while in 8 cases a tracheotomy after failed intubation secured the airway.…”
Section: Establishment Of Airway In Large Fetal Tumors In the Head Anmentioning
confidence: 99%
“…In one case of failed intubation a tracheotomy was not attempted due to parental refusal 38. The causes of the other five deaths were: impossibility to ventilate despite patent upper airway due to posterior displacement of the trachea,42 bloody pleural effusion and massive pulmonary hemorrhage,43 massive bleeding from pharyngeal portion of the tumor after manipulation of the already positioned endotracheal tube,44 respiratory distress despite established upper airway due to compression of fetal lungs through the tumor,39 bleeding into the oropharynx and distortion of upper airway anatomy precluding adequate visualization of the larynx 47. Reported EXIT‐times ranged from 2 to 54 min, with an arithmetic mean of 17.7 min.…”
Section: Establishment Of Airway In Large Fetal Tumors In the Head Anmentioning
confidence: 99%