[Ex utero intrapartum technique] (original) (raw)

Minerva anestesiologica, 2004

Abstract

Upper airway obstruction of a neonate constitutes an emergency. The ex utero intrapartum technique (EXIT) is a procedure for safely managing airway obstruction at birth, in which placental support is maintained until the airway is evaluated and secured. The anaesthetist is involved in preventing uterine contractions that impair oxygenation of the foetus and cause placental separation, in providing foetal anaesthesia to help airway manipulations, in maintaining foetal pattern of circulation, in preventing and treating maternal hypotension and in resuscitating the neonate. General anaesthesia with high concentration of inhalational agents is preferred as it provides surgical tocolysis and foetal anaesthesia. Additional uterine relaxation may be obtained using tocolytic drugs like nitroglycerin or beta-adrenergic agonists. During EXIT the foetus is delivered only as far as the shoulders or thorax leaving the cord entirely in utero to maximize the duration of placental support and to mi...

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