Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series

Ex-utero intrapartum treatment (EXIT) is a rare surgical procedure performed intrapartum in cases of anticipated fetal abnormalities. The most important anesthetic consideration for the EXIT procedure is maintaining fetomaternal circulation during the operation through uterine relaxation with anesth...

Full description

Bibliographic Details
Main Authors: Adriana Jardine, Berta Lowta Welantika, Mariza Fitriati, Manggala Pasca Wardhana
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Bali Journal of Anesthesiology
Subjects:
Online Access:http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2023;volume=7;issue=3;spage=173;epage=176;aulast=Jardine
_version_ 1797649513206251520
author Adriana Jardine
Berta Lowta Welantika
Mariza Fitriati
Manggala Pasca Wardhana
author_facet Adriana Jardine
Berta Lowta Welantika
Mariza Fitriati
Manggala Pasca Wardhana
author_sort Adriana Jardine
collection DOAJ
description Ex-utero intrapartum treatment (EXIT) is a rare surgical procedure performed intrapartum in cases of anticipated fetal abnormalities. The most important anesthetic consideration for the EXIT procedure is maintaining fetomaternal circulation during the operation through uterine relaxation with anesthetic gases in general anesthesia or nitroglycerin in regional anesthesia. Two patients were initially scheduled for elective C-sections under neuraxial anesthesia, but due to a premature rupture of the membrane and deceleration of the fetal heart rate, one was carried out as planned, and the other was converted to general anesthesia. In the second case, anesthetic gases were used to achieve uterine relaxation, whereas in the first case, oxytocin was delayed. Mothers were transferred to the low-care ward, whereas infants were transferred to the neonatal intensive care unit and underwent definitive surgery within 1–2 weeks after birth. The EXIT procedure could be used under general and regional anesthesia in elective and emergency settings.
first_indexed 2024-03-11T15:47:14Z
format Article
id doaj.art-92a4e579ba824b85af1ec3a8c463ec39
institution Directory Open Access Journal
issn 2549-2276
language English
last_indexed 2024-03-11T15:47:14Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Bali Journal of Anesthesiology
spelling doaj.art-92a4e579ba824b85af1ec3a8c463ec392023-10-26T06:05:07ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762023-01-017317317610.4103/bjoa.bjoa_98_23Anesthetic consideration for ex-utero intrapartum treatment procedure: A case seriesAdriana JardineBerta Lowta WelantikaMariza FitriatiManggala Pasca WardhanaEx-utero intrapartum treatment (EXIT) is a rare surgical procedure performed intrapartum in cases of anticipated fetal abnormalities. The most important anesthetic consideration for the EXIT procedure is maintaining fetomaternal circulation during the operation through uterine relaxation with anesthetic gases in general anesthesia or nitroglycerin in regional anesthesia. Two patients were initially scheduled for elective C-sections under neuraxial anesthesia, but due to a premature rupture of the membrane and deceleration of the fetal heart rate, one was carried out as planned, and the other was converted to general anesthesia. In the second case, anesthetic gases were used to achieve uterine relaxation, whereas in the first case, oxytocin was delayed. Mothers were transferred to the low-care ward, whereas infants were transferred to the neonatal intensive care unit and underwent definitive surgery within 1–2 weeks after birth. The EXIT procedure could be used under general and regional anesthesia in elective and emergency settings.http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2023;volume=7;issue=3;spage=173;epage=176;aulast=Jardineex-utero intrapartum treatment procedureexit proceduregeneral anesthesianeuraxial anesthesiaregional anesthesia
spellingShingle Adriana Jardine
Berta Lowta Welantika
Mariza Fitriati
Manggala Pasca Wardhana
Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
Bali Journal of Anesthesiology
ex-utero intrapartum treatment procedure
exit procedure
general anesthesia
neuraxial anesthesia
regional anesthesia
title Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
title_full Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
title_fullStr Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
title_full_unstemmed Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
title_short Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series
title_sort anesthetic consideration for ex utero intrapartum treatment procedure a case series
topic ex-utero intrapartum treatment procedure
exit procedure
general anesthesia
neuraxial anesthesia
regional anesthesia
url http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2023;volume=7;issue=3;spage=173;epage=176;aulast=Jardine
work_keys_str_mv AT adrianajardine anestheticconsiderationforexuterointrapartumtreatmentprocedureacaseseries
AT bertalowtawelantika anestheticconsiderationforexuterointrapartumtreatmentprocedureacaseseries
AT marizafitriati anestheticconsiderationforexuterointrapartumtreatmentprocedureacaseseries
AT manggalapascawardhana anestheticconsiderationforexuterointrapartumtreatmentprocedureacaseseries