Ex-utero intrapartum treatment (or exit procedure) in a case of cervical linfangiona
Introduction: Foetuses with prenatal diagnosis of anatomical malformations/masses involving face or neck are at high risk of airway obstruction from the immediate postnatal. Programming peripartum measures that prevent airway compression, maintaining adequate preservation of fetal circulation, are fundamental for prognosis.
Clinical case: We present a case report of a fetus with ultrasound diagnosis at 31 weeks’ gestation of a cervical and facial bulky mass, compatible with cystic lymphangioma. The case was discussed in an interdisciplinary team, who decided that a cesarean delivery associated with the EXIT procedure would be performed at 39 weeks of gestation. After exteriorization of the fetal head, a right cervical and facial mass was found and fetus was subjected to oro-tracheal intubation in the first minute. On the sixth day of life surgery was performed, with partial extraction of the mass.
Conclusion: The EXIT procedure allows an adequate fetal oxygenation while establishing an safe airway. Proper coordination of the multidisciplinary team is crucial to the success of the technique.
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