Obstetric outcomes of ex-utero intrapartum treatment (EXIT).
Adolescent
Adult
Airway Obstruction
/ congenital
Cesarean Section
/ adverse effects
Female
Fetal Diseases
/ epidemiology
Humans
Hysterotomy
/ adverse effects
Infant, Newborn
Intraoperative Care
/ adverse effects
Intubation, Intratracheal
/ adverse effects
Male
Obstetric Labor Complications
/ epidemiology
Postoperative Complications
/ epidemiology
Pregnancy
Pregnancy Outcome
/ epidemiology
Retrospective Studies
Treatment Outcome
Uterus
/ surgery
Young Adult
Journal
Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
04
03
2019
revised:
02
05
2019
accepted:
03
05
2019
pubmed:
17
5
2019
medline:
2
6
2020
entrez:
17
5
2019
Statut:
ppublish
Résumé
The ex-utero intrapartum treatment (EXIT) procedure is used to secure effective gas exchange prior to postnatal life. We describe the obstetrical course and maternal outcomes of a series of patients who underwent EXIT. This is a review of all pregnancies in which fetuses were delivered by EXIT from January 2001 to April 2018. Outcome variables included estimated gestational age (EGA) at delivery, need for emergency EXIT, maternal estimated blood loss (EBL), need for maternal blood transfusion, and maternal postoperative length of hospital stay. Data were tested for normality and reported as median [range] and n (%). A total of 45 patients were delivered by EXIT procedure. Sixteen (35.6%) of the EXIT procedures were performed emergently. Median maternal EBL was 800 (500-2000) mL; 6 (13.3%) patients received blood transfusion. Median maternal postoperative length of hospital stay was four [3-7] days. Our data highlight the complexity of the obstetrical management in the EXIT procedure as evidenced by an approximately 36% chance of emergency delivery. Despite having an experienced multidisciplinary team, 13.3% of our subjects underwent maternal blood transfusion. This information can be used in counseling EXIT candidates regarding the risks and benefits of this procedure.
Sections du résumé
BACKGROUND/PURPOSE
The ex-utero intrapartum treatment (EXIT) procedure is used to secure effective gas exchange prior to postnatal life. We describe the obstetrical course and maternal outcomes of a series of patients who underwent EXIT.
METHODS
This is a review of all pregnancies in which fetuses were delivered by EXIT from January 2001 to April 2018. Outcome variables included estimated gestational age (EGA) at delivery, need for emergency EXIT, maternal estimated blood loss (EBL), need for maternal blood transfusion, and maternal postoperative length of hospital stay. Data were tested for normality and reported as median [range] and n (%).
RESULTS
A total of 45 patients were delivered by EXIT procedure. Sixteen (35.6%) of the EXIT procedures were performed emergently. Median maternal EBL was 800 (500-2000) mL; 6 (13.3%) patients received blood transfusion. Median maternal postoperative length of hospital stay was four [3-7] days.
CONCLUSION
Our data highlight the complexity of the obstetrical management in the EXIT procedure as evidenced by an approximately 36% chance of emergency delivery. Despite having an experienced multidisciplinary team, 13.3% of our subjects underwent maternal blood transfusion. This information can be used in counseling EXIT candidates regarding the risks and benefits of this procedure.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
643-646Informations de copyright
© 2019 John Wiley & Sons, Ltd.