The EXIT procedure, or ex utero intrapartum treatment procedure, is a specialized surgical delivery procedure used to deliver babies who have airway compression[1] due to bronchopulmonary sequestration, congenital cystic adenomatoid malformation, cervical teratoma, or other congenital disorder. A pulmonary sequestration, also known as a bronchopulmonary sequestration or a cystic lung lesion, is a medical condition where a piece of tissue that develops into Congenital cystic adenomatoid malformation (CCAM is a Congenital disorder similar to Bronchopulmonary sequestration. A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" A congenital disorder is a disease or disorder that is present at birth
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Process
The EXIT is an extension of a standard classical Caesarean section, where an opening is made on the midline of the anesthetized mother's abdomen and uterus. A Caesarean section (or Cesarean section in American English) also known as C-section, is a form of Childbirth in which a surgical Then comes the EXIT: the baby is partially delivered through the opening but remains attached by its umbilical cord to the placenta, while a pediatric or neonatal general surgeon establishes an airway so the fetus can breathe. In placental Mammals the umbilical cord (also called the birth cord or funiculus umbilicalis) is the connecting cord from the developing Embryo The placenta is an Ephemeral organ present in placental Vertebrates, such as Eutherial Mammals and Sharks during Gestation Once the EXIT is complete, the umbilical cord is cut and clamped, and the infant is fully delivered. Then the remainder of the C-section proceeds.
Challenges
The EXIT is much more complex than a standard C-section, as it requires careful coordination between the mother's physicians and the specialists operating on the newborn baby. The difficulty lies in preserving enough blood flow through the umbilical cord, protecting the placenta, and avoiding contractions of the uterus so that there is sufficient time to establish the airway.
References
- ^ Hirose S, Farmer DL, Lee H, Nobuhara KK, Harrison MR (2004). "The ex utero intrapartum treatment procedure: Looking back at the EXIT". J. Pediatr. Surg. 39 (3): 375–80; discussion 375–80. PMID 15017555.
- Bouchard S, Johnson MP, Flake AW, et al (2002). "The EXIT procedure: experience and outcome in 31 cases". J. Pediatr. Surg. 37 (3): 418–26. PMID 11877660.
See also
Fetal intervention involves In utero surgical treatment of a Fetus.Dapyx Software network: MP3 Explorer | Ebook Manager | Zenithic