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Neuraxial block for EXIT procedure (ex utero intrapartum treatment) - A case report and literature review.

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Title: Neuraxial block for EXIT procedure (ex utero intrapartum treatment) - A case report and literature review.
Authors: Garza-Gutiérrez, Patricia M.1, Millán-Cornejo, Gustavo1, Vázquez-Guerra, Gabriela A.1, Garduño-Chávez, Belia Inés1, Palacios-Ríos, Dionicio1
Source: Medicina Universitaria. Jul-Sep2018, Vol. 20 Issue 3, p129-132. 4p.
Subjects: INTRAPARTUM care, NERVE block, AIRWAY (Anatomy), UTERINE surgery, CESAREAN section, DIAPHRAGMATIC hernia, TREATMENT of respiratory obstructions, OXYGENATORS
Abstract: Introduction: The ex utero intrapartum treatment (EXIT) involves the partial removal of the fetus from the uterine cavity during a cesarean section while maintaining placental circulation and oxygenation. This procedure is indicated when we expect a difficult access to the respiratory airway. Clinical Case: A 33-year-old female patient, with 35.4 weeks of pregnancy and a diagnosis of placenta accreta and a fetus with Bochdaleck's diaphragmatic hernia diagnosed by prenatal ultrasound, was scheduled for elective cesarean with the EXIT procedure. The chosen anesthetic technique for the patient was neuraxial anesthesia. Conclusion: The EXIT procedure is a challenge for the anesthesiologist, and they should be aware and prepared for the physiological changes of pregnancy and uteroplacental physiology. This case demonstrates that even though the preferred technique in the EXIT procedure is general anesthesia, it can also be performed effectively and safely under a neuraxial technique with invasive monitoring. [ABSTRACT FROM AUTHOR]
Copyright of Medicina Universitaria is the property of Medicina Universitaria and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
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PubType: Academic Journal
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  Data: Neuraxial block for EXIT procedure (ex utero intrapartum treatment) - A case report and literature review.
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  Data: <searchLink fieldCode="JN" term="%22Medicina+Universitaria%22">Medicina Universitaria</searchLink>. Jul-Sep2018, Vol. 20 Issue 3, p129-132. 4p.
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  Data: <searchLink fieldCode="DE" term="%22INTRAPARTUM+care%22">INTRAPARTUM care</searchLink><br /><searchLink fieldCode="DE" term="%22NERVE+block%22">NERVE block</searchLink><br /><searchLink fieldCode="DE" term="%22AIRWAY+%28Anatomy%29%22">AIRWAY (Anatomy)</searchLink><br /><searchLink fieldCode="DE" term="%22UTERINE+surgery%22">UTERINE surgery</searchLink><br /><searchLink fieldCode="DE" term="%22CESAREAN+section%22">CESAREAN section</searchLink><br /><searchLink fieldCode="DE" term="%22DIAPHRAGMATIC+hernia%22">DIAPHRAGMATIC hernia</searchLink><br /><searchLink fieldCode="DE" term="%22TREATMENT+of+respiratory+obstructions%22">TREATMENT of respiratory obstructions</searchLink><br /><searchLink fieldCode="DE" term="%22OXYGENATORS%22">OXYGENATORS</searchLink>
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  Data: Introduction: The ex utero intrapartum treatment (EXIT) involves the partial removal of the fetus from the uterine cavity during a cesarean section while maintaining placental circulation and oxygenation. This procedure is indicated when we expect a difficult access to the respiratory airway. Clinical Case: A 33-year-old female patient, with 35.4 weeks of pregnancy and a diagnosis of placenta accreta and a fetus with Bochdaleck's diaphragmatic hernia diagnosed by prenatal ultrasound, was scheduled for elective cesarean with the EXIT procedure. The chosen anesthetic technique for the patient was neuraxial anesthesia. Conclusion: The EXIT procedure is a challenge for the anesthesiologist, and they should be aware and prepared for the physiological changes of pregnancy and uteroplacental physiology. This case demonstrates that even though the preferred technique in the EXIT procedure is general anesthesia, it can also be performed effectively and safely under a neuraxial technique with invasive monitoring. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Medicina Universitaria is the property of Medicina Universitaria and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.24875/RMU.M18000023
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      – Code: eng
        Text: English
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        StartPage: 129
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        Type: general
      – SubjectFull: NERVE block
        Type: general
      – SubjectFull: AIRWAY (Anatomy)
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      – SubjectFull: UTERINE surgery
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      – SubjectFull: CESAREAN section
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      – SubjectFull: DIAPHRAGMATIC hernia
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      – SubjectFull: TREATMENT of respiratory obstructions
        Type: general
      – SubjectFull: OXYGENATORS
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      – TitleFull: Neuraxial block for EXIT procedure (ex utero intrapartum treatment) - A case report and literature review.
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              Text: Jul-Sep2018
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              Y: 2018
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