In utero Fetal Intubation for a Large Neck Mass: A Minimally Invasive EXIT Option

被引：12

作者：

Chmait, Ramen H. ^{[1
]}

Chon, Andrew H. ^{[1
]}

Anselmo, Dean ^{[2
]}

Vanderbilt, Douglas L. ^{[3
]}

Townsend, Jae ^{[4
]}

Julian-Wang, Beth ^{[5
]}

Don, Debra ^{[6
]}

机构：

[1] Univ Southern Calif, Keck Sch Med, Div Maternal Fetal Med, Dept Obstet & Gynecol, Los Angeles, CA 90033 USA

[2] Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Dept Surg,Div Pediat Surg,Vasc Anomalies Ctr, Los Angeles, CA 90033 USA

[3] Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Dept Pediat,Div Pediat Gen Pediat, Los Angeles, CA 90033 USA

[4] Pacific Valley Med Grp, Los Angeles, CA USA

[5] Univ Southern Calif, Keck Sch Med, Dept Obstet & Gynecol, Los Angeles, CA 90033 USA

[6] Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Dept Surg,Div Otolaryngol, Los Angeles, CA 90033 USA

来源：

FETAL DIAGNOSIS AND THERAPY | 2019年 / 45卷 / 04期

关键词：

Ex utero intrapartum treatment; EXIT procedure; Fetal airway obstruction; Fetoscopy; INTRAPARTUM TREATMENT PROCEDURE; MANAGEMENT; FETUS;

D O I：

10.1159/000487394

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Fetuses with obstructive neck and orofacial lesions have been delivered via an ex utero intrapartum treatment (EXIT) procedure to facilitate securement of the airway while on placental circulation. Pregnancy-related cardiovascular changes and technical issues unique to an EXIT procedure increase fetal and maternal risks relative to a standard cesarean section. In order to circumvent such issues, fetal endoscopic intubation has been proposed. We report a case of a fetus with a large neck mass (mixed solid and multi-loculated cystic lesion measuring 9.2 x 5.3 x 8.5 cm, neck hyperextension, protruding tongue, and serial gagging movements) that was successfully intubated in utero and delivered at 36 weeks and 0 days via standard cesarean section, thereby avoiding an EXIT procedure. The risks, benefits, and technical issues of in utero tracheal intubation are reviewed. (c) 2018 S. Karger AG, Basel

引用

页码：275 / 280

页数：6

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