Ex utero intrapartum treatment (EXIT) for fetal neck masses: A tertiary center experience and literature review
| Autor: | Barrie Suskin, John Bent, Mona Gangar, Christina J. Yang, Pe'er Dar, Catherina Yang, Sydney Jiang, Michel Nassar |
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| Rok vydání: | 2019 |
| Předmět: |
Polyhydramnios
medicine.medical_specialty Radiography Neck mass Ultrasonography Prenatal Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Peripartum Period Humans 030223 otorhinolaryngology Fetal neck business.industry Incidence (epidemiology) General Medicine medicine.disease Magnetic Resonance Imaging Airway Obstruction Fetal Diseases Otorhinolaryngology Aerodigestive Tract In utero Head and Neck Neoplasms Pediatrics Perinatology and Child Health Female Radiology medicine.symptom business Airway |
| Zdroj: | International journal of pediatric otorhinolaryngology. 127 |
| ISSN: | 1872-8464 |
| Popis: | Objective Currently no established criteria exist to guide use of ex utero intrapartum treatment (EXIT) for fetal neck mass management. This study aims to correlate prenatal radiographic findings with incidence of ex utero intrapartum treatment and necessity of airway intervention at delivery. Methods We reviewed our EXIT experience between 2012 and 17. Furthermore, we performed a literature review of articles reporting incidences of fetal neck masses considered for EXIT. Articles that were included (1) discussed prenatal radiographic findings such as size, features, and evidence of compression and (2) reported extractable data on delivery outcomes and airway status. Results Ten cases at our institution were reviewed. Another 137 cases across 81 studies met inclusion criteria. These studies showed aerodigestive tract compression to be significantly associated with neck masses undergoing EXIT. Additionally, there was significantly higher incidence of airway intervention in cases where polyhydramnios, anatomic compression, and solid masses were seen on prenatal diagnostic imaging, while mass location and size did not correlate with airway intervention. Conclusion With this data, we propose that any neck mass with anatomic compression on fetal imaging in the 3rd trimester should be considered for EXIT. When radiographic findings do not show compression but do display polyhydramnios or a solid neck mass (regardless of polyhydramnios), an airway surgeon should be available for perinatal airway assistance. |
| Databáze: | OpenAIRE |
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