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Ex utero intrapartum treatment

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https://www.readbyqxmd.com/read/29662285/ex-utero-intrapartum-treatment-exit-for-a-large-fetal-neck-mass
#1
Manisha M Beck, Ekta Rai, Reeta Vijayaselvi, Mary John, Naina Picardo, Sridhar Santhanam, Maneesh Kumar, Benjamin J Ross
No abstract text is available yet for this article.
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29508360/ex-utero-intrapartum-treatment-for-giant-congenital-omphalocele
#2
Xu-Yong Chen, Ji-Xin Yang, Hong-Yi Zhang, Xiao-Feng Xiong, Khalid Mohamoud Abdullahi, Xiao-Juan Wu, Jie-Xiong Feng
BACKGROUND: To determine whether ex utero intrapartum treatment (EXIT) is an appropriate approach for managing fetuses antenatally diagnosed with giant congenital omphaloceles. METHODS: We retrospectively reviewed patients with omphaloceles who underwent either an EXIT procedure or a traditional repair surgery. Basic and clinical parameters including gender, gestational age, birth weight, maternal blood loss, operative times and operative complications were analyzed...
March 5, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29495013/high-tumor-volume-to-fetal-weight-ratio-is-associated-with-worse-fetal-outcomes-and-increased-maternal-risk-in-fetuses-with-sacrococcygeal-teratoma
#3
Juliana S Gebb, Nahla Khalek, Huma Qamar, Mark P Johnson, Edward R Oliver, Beverly G Coleman, William H Peranteau, Holly L Hedrick, Alan W Flake, N Scott Adzick, Julie S Moldenhauer
OBJECTIVE: Tumor volume to fetal weight ratio (TFR) > 0.12 before 24 weeks has been associated with poor outcome in fetuses with sacrococcygeal teratoma (SCT). We evaluated TFR in predicting poor fetal outcome and increased maternal operative risk in our cohort of SCT pregnancies. METHODS: This is a retrospective, single-center review of fetuses seen with SCT from 1997 to 2015. Patients who chose termination of pregnancy (TOP), delivered elsewhere, or had initial evaluation at > 24 weeks were excluded...
March 1, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29447823/exit-ex-utero-intrapartum-treatment-in-a-growth-restricted-fetus-with-tracheal-atresia
#4
S Kyle Gonzales, Steven Goudy, Kara Prickett, Jane Ellis
Congenital high airway obstruction syndrome (CHAOS) encompasses a heterogeneous group of pathologies leading to poor lung development and difficulty oxygenating the newborn after delivery. While previously uniformly fatal, the ex utero intrapartum therapy (EXIT) procedure has provided a method to treat these patients and provide an airway to potentiate survival. We present a patient diagnosed prenatally with CHAOS secondary to tracheal atresia complicated by severe intra-uterine growth restriction (IUGR) who was successfully delivered via an EXIT procedure at 33-weeks...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447817/mature-and-immature-pediatric-head-and-neck-teratomas-a-15-year-review-at-a-large-tertiary-center
#5
Harish Dharmarajan, Noémie Rouillard-Bazinet, Binoy M Chandy
INTRODUCTION: Pediatric head and neck teratomas account for less than 4% of congenital teratomas. The distinct presentations and outcomes of mature and immature head and neck teratomas have not been well established. OBJECTIVES: To review the management and outcomes of pediatric head and neck teratomas. To distinguish differences between mature and immature tumors with respect to the age at presentation and surgery, tumor size and location, alpha fetoprotein (AFP) levels, airway management, and recurrence...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29438655/short-term-neurodevelopmental-outcome-in-children-born-with-high-risk-congenital-lung-lesions
#6
Enrico Danzer, Casey Hoffman, Jo Ann D'Agostino, Matthew M Boelig, Marsha Gerdes, Judy C Bernbaum, Hannah Rosenthal, Lindsay N Waqar, Natalie E Rintoul, Lisa M Herkert, Michael J Kallan, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
BACKGROUND: This study sought to evaluate neurodevelopmental outcome in survivors of high-risk congenital lung lesions (CLLs) who underwent prenatal intervention or postnatal surgery within the first month of life. METHODS: Forty-five high-risk CLL survivors underwent assessment using the Bayley Scales of Infant Development, 3rd Edition between July 2004 and December 2016. Scores were grouped as average, at-risk, and delayed based on SD intervals. Correlations between outcome and risk factors were analyzed by Fisher's exact test or two-sided t test as appropriate, with significant p values <0...
February 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29187760/the-exit-ex-utero-intrapartum-treatment-procedure-from-the-paediatric-ent-perspective
#7
B Pucher, J Szydlowski, K Jonczyk-Potoczna, J Sroczynski
The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29049800/ex-utero-intrapartum-treatment-to-extracorporeal-membrane-oxygenation-followed-by-cardiac-operation-for-truncus-arteriosus-communis
#8
Hidetsugu Asai, Tsuyoshi Tachibana, Yasushige Shingu, Yoshiro Matsui
Extracorporeal membrane oxygenation has been recently indicated as an ex utero intrapartum treatment procedure for placental support in patients with a large thoracic mass. In our case, a foetus with truncus arteriosus communis and hydrops with ventricular failure due to severe truncal valve stenosis was delivered under ex utero intrapartum treatment-to-extracorporeal membrane oxygenation at 34 weeks of gestation. The neonate underwent truncal valve plasty. He could be weaned off extracorporeal membrane oxygenation, but he died because of the infection on postnatal Day 24...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28992728/use-of-ex-utero-intrapartum-treatment-procedure-in-fetal-neck-and-high-airway-anomalies-report-of-four-clinical-cases
#9
Jakub Kornacki, Jarosław Szydłowski, Jana Skrzypczak, Małgorzata Szczepańska, Marcin Rajewski, Agnieszka Koziołek, Michał Gaca, Ewa Wender-Ożegowska
PURPOSE: To present antenatal management and use of ex utero intrapartum treatment (EXIT) in different fetal neck and high airway anomalies. MATERIAL AND METHODS: We have presented four different cases of fetal neck or airway pathology which were indications for EXIT, at our department. RESULTS: In three cases of fetal neck tumors, the primary precise antenatal diagnoses of tumors were confirmed after birth. The airways of all three fetuses were properly secured during EXIT by laryngologist...
October 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28949025/perinatal-diagnosis-and-management-of-oropharyngeal-fetus-in-fetu-a-case-report
#10
Yangyang R Yu, Jimmy Espinoza, Deepak K Mehta, Sundeep G Keswani, Timothy C Lee
Fetus in fetu is an extremely rare congenital anomaly. We describe the perinatal diagnosis and management of a fetus with oropharyngeal and cervical fetus in fetu. High-resolution ultrasonography with 3-dimensional rendering can identify increased risks of airway obstruction in utero. Early identification allows a multidisciplinary team to be assembled for a scheduled ex utero intrapartum treatment procedure. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound, 2017.
September 26, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28915526/-exit-a-possible-intervention-for-new-and-earlyborn-babies-with-severe-hydrops-fetalis-and-hydrothoraces-on-both-sides
#11
Sandra Koch, Jochen Essers, Ortraud Beringer, Frank Reister, Helmut Hummler, Anja Moewes
The EXIT (ex utero intrapartum treatment) procedure is an established method of respiratory protection, originally used in the delivery of fetuses with congenital obstructive airway diseases (tumors in the throat area, hygromas, so-called congenital high airway obstruction syndrome (CHAOS)). Meanwhile, the procedure is also carried out in large perinatal centers for pronounced diaphragmatic hernia or other special indications (EXIT to ECMO, congenital lung airway malformations (CCAM), pulmonary atresia). We present our experience with adapted EXIT procedures in 5 preterm infants with secondary generalized hydrops fetalis and pronounced bilateral hydrothoraces...
December 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28805620/ex-utero-intrapartum-treatment-for-extremely-low-birth-weight-neonates-requiring-resuscitation-at-birth
#12
Tai-Ho Hung, Ting-Xuan Huang, T'sang-T'ang Hsieh
OBJECTIVE: Difficulties often encountered during intubation in extremely low birth-weight (ELBW) neonates requiring resuscitation at birth because of the smaller airway and the pressure from the limited number of attempts before hemodynamic instability occurs. CASE REPORT: We evaluated two pregnant women at 26 weeks of gestation with premature rupture of membranes and evidence of chorioamnionitis and applied the concept of ex utero intrapartum treatment, which involved delaying cord clamping (DCC) after establishing a secured airway with adequate ventilation during cesarean delivery...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28580573/fetal-neck-tumors-antenatal-and-intrapartum-management
#13
Jakub Kornacki, Jana Skrzypczak
In this review article we describe the ante- and perinatal management of fetal neck tumors. Although there are rare congenital anomalies, the clinical consequences for the fetus may be fatal and include airways obstruction, heart insufficiency, pulmonary hypoplasia and cosmetic effect. The right management allows to decrease the fetal and neonatal mortality and morbidity associated with the disease. It includes intrauterine therapy in some cases, mostly in a goitrus hypothyroidism of the fetus, but firstly, an assessment of the fetal airways patency with a subsequent, eventual Ex-Utero Intrapartum Treatment (EXIT)...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28578350/ex-utero-intrapartum-treatment-to-ventricular-pacing-a-novel-delivery-strategy-for-complete-atrioventricular-block-with-severe-bradycardia
#14
Bettina F Cuneo, Max B Mitchell, Ahmed I Marwan, Matthew Green, Johannes C von Alvensleben, Regina Reynolds, Timothy M Crombleholme, Henry L Galan
Fetuses with anti-SSA-mediated complete atrioventricular block (CAVB) are at high risk for perinatal death if they present at <20 weeks of gestation and develop ventricular rates of <55 beats per minute (bpm), cardiac dysfunction, or hydrops [Izmirly et al.: Circulation 2011;124:1927-1935; Jaeggi et al.: J Am Coll Cardiol 2002;39:130-137; Eliasson et al.: Circulation 2011;124:1919-1926]. After our experience with two such fetuses who died with pulseless electrical activity despite being paced within 30 min of birth, we performed an ex utero intrapartum treatment procedure to ventricular pacing on a 36-week CAVB fetus with cardiac dysfunction, mild hydrops, and a ventricular rate of 46 bpm...
2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28571898/-recommendations-for-respiratory-support-in-the-newborn-iv-high-frequency-ventilation-ex-utero-intrapartum-treatment-exit-extracorporeal-membrane-oxygenation-ecmo
#15
Félix Castillo Salinas, Dolores Elorza Fernández, Antonio Gutiérrez Laso, Julio Moreno Hernando, Gerardo Bustos Lozano, Manuel Gresa Muñoz, Xavier Miracle Echegoyen
The recommendations included in this document will be part a series of updated reviews of the literature on respiratory support in the newborn infant. These recommendations are structured into 12 modules, and in this work module 8 is presented. Each module is the result of a consensus process amongst all members of the Surfactant and Respiratory Group of the Spanish Society of Neonatology. They represent a summary of the published papers on each specific topic, as well as the clinical experience of each one of the members of the group...
November 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28524841/ex-utero-intrapartum-treatment-for-the-pericardial-effusion-drain-of-a-fetal-cardiac-tumor
#16
Jian Zhuang, Wei Pan, Cheng-Bin Zhou, Feng-Zhen Han
No abstract text is available yet for this article.
June 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28483254/teratoma-of-the-neonatal-head-and-neck-a-41-year-experience
#17
Jacob R Brodsky, Alexandria L Irace, Amanda Didas, Karen Watters, Judy A Estroff, Carol E Barnewolt, Antonio Perez-Atayde, Reza Rahbar
OBJECTIVE: To review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population. DESIGN: Retrospective case series (November 1970 through September 2011). SETTING: Tertiary care children's hospital. PATIENTS: 14 patients (12 boys and 2 girls). INTERVENTION: Detailed review of presentation, diagnostic approaches, surgical management, and outcomes...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28365065/infantile-hemangiopericytoma-of-the-tongue-efficacy-of-ex-utero-intrapartum-treatment-procedure-and-combined-modality-therapy
#18
Takenori Ogawa, Ryo Ishii, Daiki Ozawa, Takeshi Rikiishi, Hajime Usubuchi, Mika Watanabe, Yoshimichi Imai, Kenichi Sato, Masatoshi Saito, Yoji Sasahara, Tadashi Matsuda, Shigeo Kure, Yukio Katori
Here we present an extremely rare case of giant infantile hemangiopericytoma (HPC) of the tongue diagnosed prenatally by fetal ultrasonography and MR imaging. Due to airway stenosis, the patient was delivered by the ex utero intrapartum treatment (EXIT) procedure at 36 weeks of pregnancy. Initial diagnosis was infantile hemangioma based on physical examination, diagnostic imaging and the high incidence of hemangioma. The tumor was resistant to conservative treatments. Due to severe tumor hemorrhage, the nutrient vessel was embolized by endovascular treatment on the 73th day after birth...
February 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28343178/fetal-cardiac-tumors-clinical-features-management-and-prognosis
#19
Shi-Min Yuan
Fetal cardiac tumors are rare and usually benign. While echocardiography is a reliable technique for diagnosing fetal cardiac tumors, their definitive diagnosis relies on pathological examination. The strategies used to manage fetal cardiac tumors are challenging. A good clinical result is their complete regression during pregnancy or shortly after birth, as often occurs with cardiac rhabdomyomas. Moreover, the fetal prognosis depends on the nature of the tumors, namely, their location, size, number and associated complications...
February 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28301889/geburtshilfe-an%C3%A3-sthesie-bei-exit-prozedur
#20
REVIEW
Alexander Torossian
The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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