EXIT procedure in twin pregnancy: a series of three cases from a single center

Background: Indications for the ex utero intrapartum therapy (EXIT) procedure have evolved and nowadays in addition to secure the airway, obtain vascular access, administer surfactant and other resuscitation medications, EXIT is used to resect cervical or thoracic masses, for extracorporeal membrane...

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Detalhes bibliográficos
Autores: García Díaz, Lutgardo, Agustín, Juan Carlos de, Ontanilla, Antonio, Marenco, María Luisa, Pavón, Antonio, Losada, Antonio, Antiñolo Gil, Guillermo
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Recursos:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/111879
Acesso em linha:https://hdl.handle.net/11441/111879
https://doi.org/10.1186/1471-2393-14-252
Access Level:acceso abierto
Palavra-chave:Prenatal diagnosis
Fetal medicine
Fetal intervention
Twin pregnancy
Ex utero intrapartum therapy
EXIT procedure
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spelling EXIT procedure in twin pregnancy: a series of three cases from a single centerGarcía Díaz, LutgardoAgustín, Juan Carlos deOntanilla, AntonioMarenco, María LuisaPavón, AntonioLosada, AntonioAntiñolo Gil, GuillermoPrenatal diagnosisFetal medicineFetal interventionTwin pregnancyEx utero intrapartum therapyEXIT procedureBackground: Indications for the ex utero intrapartum therapy (EXIT) procedure have evolved and nowadays in addition to secure the airway, obtain vascular access, administer surfactant and other resuscitation medications, EXIT is used to resect cervical or thoracic masses, for extracorporeal membrane circulation (ECMO) cannulation, as well as to rescue maximum intra-thoracic space for ventilation of the remaining functional lung tissue or in cases in which resuscitation of the neonate may be compromised. EXIT procedure in twin pregnancy has been rarely reported and some doubts have been raised about its strategy and safety in such cases. Methods: We reviewed the medical records of 3 twin pregnancy cases where the EXIT procedure have been performed in our center. Results: The mean gestational age at EXIT procedure was 34 + 4 weeks. In two out the three EXIT procedures, the affected twin was delivered first. The average time on placental bypass was 9 minutes. There were no fetal or maternal complications related to the EXIT procedure. All newborns are currently doing well. Conclusion: In twin pregnancies, prenatal diagnosis combined with the EXIT procedure permits the formulation of a controlled delivery strategy to secure both newborns outcome. In those pregnancies, if intervention can be accomplished without compromise of the normal twin, EXIT can be considered. Our results support that EXIT procedure, if properly planned, safely provides a good outcome for both the fetuses as well as the mother.BMCCirugía2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/111879https://doi.org/10.1186/1471-2393-14-252reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésBMC Pregnancy And Childbirth, 14 (252)https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-252info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1118792026-06-17T12:51:07Z
dc.title.none.fl_str_mv EXIT procedure in twin pregnancy: a series of three cases from a single center
title EXIT procedure in twin pregnancy: a series of three cases from a single center
spellingShingle EXIT procedure in twin pregnancy: a series of three cases from a single center
García Díaz, Lutgardo
Prenatal diagnosis
Fetal medicine
Fetal intervention
Twin pregnancy
Ex utero intrapartum therapy
EXIT procedure
title_short EXIT procedure in twin pregnancy: a series of three cases from a single center
title_full EXIT procedure in twin pregnancy: a series of three cases from a single center
title_fullStr EXIT procedure in twin pregnancy: a series of three cases from a single center
title_full_unstemmed EXIT procedure in twin pregnancy: a series of three cases from a single center
title_sort EXIT procedure in twin pregnancy: a series of three cases from a single center
dc.creator.none.fl_str_mv García Díaz, Lutgardo
Agustín, Juan Carlos de
Ontanilla, Antonio
Marenco, María Luisa
Pavón, Antonio
Losada, Antonio
Antiñolo Gil, Guillermo
author García Díaz, Lutgardo
author_facet García Díaz, Lutgardo
Agustín, Juan Carlos de
Ontanilla, Antonio
Marenco, María Luisa
Pavón, Antonio
Losada, Antonio
Antiñolo Gil, Guillermo
author_role author
author2 Agustín, Juan Carlos de
Ontanilla, Antonio
Marenco, María Luisa
Pavón, Antonio
Losada, Antonio
Antiñolo Gil, Guillermo
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Cirugía
dc.subject.none.fl_str_mv Prenatal diagnosis
Fetal medicine
Fetal intervention
Twin pregnancy
Ex utero intrapartum therapy
EXIT procedure
topic Prenatal diagnosis
Fetal medicine
Fetal intervention
Twin pregnancy
Ex utero intrapartum therapy
EXIT procedure
description Background: Indications for the ex utero intrapartum therapy (EXIT) procedure have evolved and nowadays in addition to secure the airway, obtain vascular access, administer surfactant and other resuscitation medications, EXIT is used to resect cervical or thoracic masses, for extracorporeal membrane circulation (ECMO) cannulation, as well as to rescue maximum intra-thoracic space for ventilation of the remaining functional lung tissue or in cases in which resuscitation of the neonate may be compromised. EXIT procedure in twin pregnancy has been rarely reported and some doubts have been raised about its strategy and safety in such cases. Methods: We reviewed the medical records of 3 twin pregnancy cases where the EXIT procedure have been performed in our center. Results: The mean gestational age at EXIT procedure was 34 + 4 weeks. In two out the three EXIT procedures, the affected twin was delivered first. The average time on placental bypass was 9 minutes. There were no fetal or maternal complications related to the EXIT procedure. All newborns are currently doing well. Conclusion: In twin pregnancies, prenatal diagnosis combined with the EXIT procedure permits the formulation of a controlled delivery strategy to secure both newborns outcome. In those pregnancies, if intervention can be accomplished without compromise of the normal twin, EXIT can be considered. Our results support that EXIT procedure, if properly planned, safely provides a good outcome for both the fetuses as well as the mother.
publishDate 2014
dc.date.none.fl_str_mv 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/111879
https://doi.org/10.1186/1471-2393-14-252
url https://hdl.handle.net/11441/111879
https://doi.org/10.1186/1471-2393-14-252
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Pregnancy And Childbirth, 14 (252)
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-252
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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