Title
EXIT (ex utero intrapartum treatment) surgery for the management of fetal airway obstruction: A systematic review of the literature
Date Issued
01 July 2020
Access level
metadata only access
Resource Type
review
Author(s)
Publisher(s)
W.B. Saunders
Abstract
Purpose: To provide a comprehensive overview of the perinatal and maternal outcomes of fetuses undergoing EXIT surgery for the management of fetal airway obstruction secondary to cervical or oral tumors. Methods: A comprehensive search from inception to September 2018 was conducted on databases including MEDLINE, EMBASE, Cochrane Library and LILACS. All studies that reported an EXIT surgery in singleton were considered eligible. A descriptive analysis was performed. Results: Out of the 250 full-text study reports, 120 articles reporting 235 cases of EXIT surgery were included. EXIT surgery was performed at 35.1 weeks of gestation on average. The most frequent diagnosis was teratoma (46.4%, n = 109/235). There were 13 adverse maternal events, and the most frequent one was postpartum hemorrhage (4.7%, n = 11/235). No maternal death was reported. Fetal and neonatal death occurred in 17% (40/235) of the cases. There were 29 adverse fetal events (12.2%), and the most frequent one was the failure of intubation or tracheostomy (3.4%, n = 8/235). Conclusion: EXIT surgery could be considered for the management of an oral or cervical tumor that's highly suspicious of blocking the fetal airway. This systematic review reports that EXIT surgery poses substantial risks of maternal and fetal adverse events, including neonatal death. Level of Evidence: IV case series with no comparison group.
Start page
1188
End page
1195
Volume
55
Issue
7
Language
English
OCDE Knowledge area
Sistema respiratorio
Cirugía
Subjects
Scopus EID
2-s2.0-85081249688
PubMed ID
Source
Journal of Pediatric Surgery
ISSN of the container
00223468
Sponsor(s)
The authors thank Romina Tejada Caminiti, MD (Instituto Nacional de Salud del Peru) for her valuable assistance. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Sources of information:
Directorio de Producción Científica
Scopus