Subramanian Rajkumar, Mishra Pallavi, Subramaniam Rajeshwari, Bansal Sumit
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Department of Anaesthesiology, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
J Anaesthesiol Clin Pharmacol. 2018 Apr-Jun;34(2):148-154. doi: 10.4103/joacp.JOACP_239_16.
The intrapartum treatment (EXIT) procedure is a rare form of perinatal resuscitation. It is basically a bridge therapy between partial delivery of the child and stabilization of its cardiorespiratory functions. This procedure has multiple anesthetic challenges including maternal anesthesia, maintenance of uteroplacental flow, tocolysis till the neonate is stabilized, management of postpartum hemorrhage, fetal, and neonatal anesthesia. This review also describes a case of cervical teratoma in fetus, for which the EXIT was performed in our institute. In addition to the case description, multiple concerns specific for EXIT procedure are discussed in this review.
产时处理(EXIT)程序是一种罕见的围产期复苏形式。它基本上是在胎儿部分娩出与其心肺功能稳定之间的一种过渡治疗。该程序存在多种麻醉挑战,包括产妇麻醉、维持子宫胎盘血流、在新生儿稳定前进行宫缩抑制、产后出血的处理、胎儿及新生儿麻醉。本综述还描述了我院为一名患有宫颈畸胎瘤的胎儿实施EXIT程序的病例。除病例描述外,本综述还讨论了EXIT程序特有的多个问题。