• Diego A Preciado, Michael J Rutter, James M Greenberg, Ray Bahado-Singh, Donna Lambers, and J Paul Willging.
• Department of Pediatric Otolaryngology, 3333 Burnet Avenue, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
• J Otolaryngol. 2004 Oct 1; 33 (5): 283-8.

ObjectiveTo review our experience with the planned intrapartum management of fetuses with suspected severe airway obstruction.MethodsRetrospective review of prenatal presentations, intrapartum airway procurement methods, outcomes, and complications.ResultsAll cases (N = 11) at our tertiary airway referral institution between 1995 and 2002 were reviewed. Obstruction was secondary to giant cervicofacial lymphangiomas (5), teratomas (2), epignathis (1), epulis (1), conjoined fetus (1), and tracheal foreign body (1). Elective cesarean delivery of the entire fetus was performed while maintaining fetal-placental circulation as long as possible. We found it necessary to deliver the entire fetus to improve airway exposure and decrease maternal hemorrhage. The airway was secured effectively in all cases.ConclusionsAlthough full cesarean delivery of the fetus significantly reduces fetal-placental circulation times, in comparison with the formal ex utero intrapartum treatment (EXIT) procedure, airway access is improved, maternal complications may be decreased, and high airway procurement success is still safely achieved.

38 keywords...

hide…