Prenatal Tanılı Servikal Kitleye Ekstrauterin İntrapartum Tedavi ((EXIT) Yöntemiyle Yaklaşım

Abstract

A patient with prenatal diagnosis of a cervical mass compressing the trachea managed by the the exutero intrapartum treatment (EXIT) at birth was detailed. The patient had presented with polyhydramnios and a cervical mass during the prenatal period. At the thirty-seventh gestational week, decision was given to perform the delivery with the EXIT procedure. The baby was delivered by cesarean section under general anesthesia, with the entire team ready to be sterile intraoperatively. The baby was intubated oropharyngeally without clamping the cord to preserve uteroplacental and placento-fetal circulation. The cord was then clamped and the patient taken to the neonatal intensive care unit under stable condition. On the 2nd postnatal day, cervical CT showed a 65x65x55 mm solid mass lesion, which was totally excised on the 3rd postnatal day.Histopathological examination revealed an immature teratoma. The patient is well and without any clinical problem in the 3th postoperative year of follow-up. The EXIT procedure is an effective treatment option in cervical masses that cause severe airway obstruction during the prenatal period, as it preserves placentofetal circulation until safe airway is achieved. Multidisciplinary approach and planning is required for safe performance of this advanced perinatal resuscitation technique.