Prickett Kara, Javia Luv
Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, 1400 Tullie Road, NE, Atlanta, GA 30329, USA.
Cochlear Implant Program, Center for Pediatric Airway Disorders, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Clin Perinatol. 2018 Dec;45(4):609-628. doi: 10.1016/j.clp.2018.07.003.
Congenital causes of airway obstruction once noted at birth are now diagnosed prenatally. The adoption of ex utero intrapartum treatment has allowed for planned airway stabilization on placental support, dramatically decreasing the incidence of hypoxic injury or peripartum demise related to neonatal airway obstruction. Airway access is gained either through laryngoscopy, bronchoscopy, or a surgical airway. In complete airway obstruction, primary resection of the obstructing lesion may be performed before completion of delivery. This article reviews the current and emerging methods of fetal evaluation, indications for ex utero intrapartum treatment, and provides a detailed description of the procedure and necessary personnel.
曾经在出生时才被发现的先天性气道梗阻病因，现在已能在产前做出诊断。子宫外产时处理的应用使得在胎盘支持下对气道进行计划性稳定成为可能，显著降低了与新生儿气道梗阻相关的缺氧性损伤或围产期死亡的发生率。通过喉镜检查、支气管镜检查或手术建立气道通路。在完全性气道梗阻时，可在分娩完成前对梗阻性病变进行一期切除。本文回顾了当前及新出现的胎儿评估方法、子宫外产时处理的适应证，并详细描述了该操作及所需人员。
