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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 11

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Ginecol Obstet Mex 2019; 87 (11)

EXIT (Ex-Utero Intrapartum Treatment) as a treatment option in fetuses with a high risk of death: a systematic review

Novoa RH, Quintana W, Ventura W

Language: Spanish
References: 83
Page: 769-780
PDF size: 401.89 Kb.


ABSTRACT

Objectives: To describe the characteristics of the patients, the surgical technique and maternal and fetal complications of the EXIT (Ex-Utero Intrapartum Treatment) surgery that do not include oral or cervical tumors.
Methodology: Systematic review of the literature that included searches in MEDLINE, EMBASE, Cochrane Library and LILACS until September 2018 of all reports or case series of EXIT surgery. Two authors made the selection, evaluation and extraction of data. A descriptive analysis was then carried out.
Resultados: We included 71 full text study reports that included 242 cases of EXIT surgery. The most frequent indication was the management of fetal airway in diaphragmatic hernia (92%). EXIT surgery was performed on average at 34.4 weeks of gestation. The access to ensure the fetal airway was 77% through orotracheal intubation. No maternal deaths were reported, and overall perinatal survival was 77%.
Conclusions: EXIT surgery is a safe procedure for the fetus and for the mother and has different indications, the most frequent was endotracheal balloon removal in the treatment of diaphragmatic hernia.


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