Premium
PS14
FACTORS INFLUENCING THE TIMING OF THE EXIT PROCEDURE FOR OBSTRUCTING FETAL NECK MASSES
Author(s) -
Jefferies H. M.,
Beasley S. W.,
Blakelock R. T.,
Kyle B. V.,
Dixon A. P.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04125_14.x
Subject(s) - medicine , polyhydramnios , fetus , swallowing , obstetrics , lymphangioma , airway obstruction , airway , pregnancy , in utero , neck mass , surgery , genetics , biology
The EXIT procedure (ex‐utero intra‐partum treatment) has become the standard modality for dealing with a fetus when it is anticipated that there will be major problems establishing an airway at the time of birth. Rapid growth and expansion of cervical masses (most commonly cervical teratoma or lymphangioma) may deviate and compress the trachea and oesophagus, and obstruct fetal swallowing. This may cause severe maternal polyhydramnios and places the fetus at risk of death. Cervical masses first diagnosed between 20–24 weeks gestation may be observed to grow rapidly on serial ultrasonography, and require repeated amnio‐reduction and drainage of the cyst. The risks of multiple interventions to prolong the pregnancy, the rate of expansion of the solid component of the tumour, and of uterine death have to be balanced against the risks associated with extreme prematurity and delivery by the EXIT procedure to establish an airway.