Cesarean section with operation on placental support as an adapted EXIT procedure for fetal thyroid goiter: A case report and literature review
Issued Date
2024-01-01
Resource Type
ISSN
00207292
eISSN
18793479
Scopus ID
2-s2.0-85211002391
Journal Title
International Journal of Gynecology and Obstetrics
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Gynecology and Obstetrics (2024)
Suggested Citation
Diawtipsukon S., Moradokkasem W., Chansriniyom N., Nuntnarumit P. Cesarean section with operation on placental support as an adapted EXIT procedure for fetal thyroid goiter: A case report and literature review. International Journal of Gynecology and Obstetrics (2024). doi:10.1002/ijgo.16060 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/102365
Title
Cesarean section with operation on placental support as an adapted EXIT procedure for fetal thyroid goiter: A case report and literature review
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
The ex-utero intrapartum treatment (EXIT) procedure is a specialized delivery strategy that extends utero–placental–fetal circulation to convert a potential neonatal emergency condition into a condition that is compatible with postnatal life. Cesarean section with operation on placental support is an EXIT technique that requires a relatively short duration of placental support and few skilled medical personnel and specialized instruments; it can successfully treat selected fetal indications. In the present study, we report a case of fetal thyroid goiter as an example of a fetal anomaly requiring the procedure. We then review all cases published in the medical literature that were similar to our procedure (15 cases including our new case). Twelve (80%) cases of fetal anomalies and three prophylactic cases of extremely low birth weight were delivered using a procedure adapted from the standard EXIT procedure. All 12 cases of fetal anomalies were treated by airway intervention. In 12 of the 15 cases (80%), direct laryngoscopy and endotracheal intubation were attempted; intubation was successful in seven of these 12 cases (58%). There was only one case of postpartum hemorrhage caused by uterine incisional bleeding, with a consequence of delayed hysterotomy closure. In summary, cesarean section with operation on placental support is a promising alternative delivery technique for neonates with airway obstructive lesions, especially in resource-limited settings.