Kornacki Jakub, Szydłowski Jarosław, Skrzypczak Jana, Szczepańska Małgorzata, Rajewski Marcin, Koziołek Agnieszka, Gaca Michał, Wender-Ożegowska Ewa
a Division of Reproduction , Poznan University of Medical Sciences , Poznań , Poland.
b Department of Pediatric Otorhinolaryngology , Poznan University of Medical Sciences , Poznań , Poland.
J Matern Fetal Neonatal Med. 2019 Mar;32(5):870-874. doi: 10.1080/14767058.2017.1390740. Epub 2017 Oct 26.
To present antenatal management and use of ex utero intrapartum treatment (EXIT) in different fetal neck and high airway anomalies.
We have presented four different cases of fetal neck or airway pathology which were indications for EXIT, at our department.
In three cases of fetal neck tumors, the primary precise antenatal diagnoses of tumors were confirmed after birth. The airways of all three fetuses were properly secured during EXIT by laryngologist. All these newborns survived. In the fourth case, a primary, antenatal diagnosis of congenital high airway obstruction syndrome due to severe trachea obstruction was not confirmed after birth. Finally, due to complete trachea dysgenesis, neither tracheoscopy nor tracheostomy was done during EXIT and the baby died.
Despite a failure of intrapartum treatment in the fourth case, we strongly recommend this procedure for deliveries of fetuses with a suspicion of airway obstruction.
介绍不同胎儿颈部及高位气道异常情况下的产前管理及宫外产时处理（EXIT）的应用。
我们展示了在本部门出现的4例胎儿颈部或气道病变病例，这些病例均为EXIT的适应证。
在3例胎儿颈部肿瘤病例中，出生后证实了产前对肿瘤的初步准确诊断。在EXIT过程中，3例胎儿的气道均由喉科医生妥善保障。所有这些新生儿均存活。在第4例中，出生后未证实产前对因严重气管阻塞导致的先天性高位气道梗阻综合征的初步诊断。最终，由于完全性气管发育不全，EXIT期间既未进行气管镜检查也未进行气管切开术，婴儿死亡。
尽管第4例产时治疗失败，但我们强烈推荐对怀疑气道阻塞的胎儿进行该操作。
