Butler Colin R, Maughan Elizabeth F, Pandya Pranav, Hewitt Richard
aDepartment of Otolaryngology, Great Ormond Street Hospital for Children NHS Foundation TrustbFetal Medicine Unit, University College London Hospital NHS Trust, London, UK.
Curr Opin Otolaryngol Head Neck Surg. 2017 Apr;25(2):119-126. doi: 10.1097/MOO.0000000000000343.
Improvements in the antenatal diagnosis of congenital malformations have led to increased detection of fetal airway obstructing lesions, and pediatric ear, nose, and throat surgeons are increasingly involved in these cases.
This article outlines the typical range of pathology seen, the logistics in providing support for anticipated deliveries and the multidisciplinary management of complex airway cases.
Traditionally, difficulty in obtaining a patent airway at delivery was a major factor in the dismal prognosis of these pregnancies. The ex utero intrapartum treatment procedure, which involves controlled partial delivery of the fetus whilst maintaining placental circulation, allows various airway maneuvers to be performed to secure the airway in a controlled fashion.
先天性畸形产前诊断的改善使得胎儿气道阻塞性病变的检出率增加，小儿耳鼻喉科医生越来越多地参与到这些病例的治疗中。
本文概述了所见病理的典型范围、为预期分娩提供支持的相关事宜以及复杂气道病例的多学科管理。
传统上，分娩时难以获得通畅气道是这些妊娠预后不良的主要因素。宫外产时治疗程序，即在维持胎盘循环的同时控制胎儿部分娩出，允许以可控方式进行各种气道操作以确保气道安全。
