Zusammenfassung
Bei der EXIT-Prozedur („ex-utero intra-partum treatment“) erfolgt eine invasive Versorgung des Feten im Rahmen einer Sectio caesarea noch vor Unterbindung der Nabelschnur. Die Aufrechterhaltung der plazentaren Perfusion für die Dauer des Eingriffs erfordert ein spezielles anästhesiologisches und operatives Vorgehen. Berichtet wird der Fall einer 33-jährigen Patientin, bei der aufgrund eines großen Halstumors des Feten mit 36 Schwangerschaftswochen (SSW) eine EXIT-Prozedur in Allgemeinanästhesie zur kindlichen Atemwegssicherung durchgeführt wurde. Das anästhesiologische Vorgehen und die interdisziplinäre Aufgabenstellung werden im Kontext der Literaturdaten diskutiert.
Abstract
The ex-utero intra-partum (EXIT) procedure enables the surgeon to perform invasive procedures in an infant during cesarean section before clamping the umbilical cord. Specific anesthesiological concepts are necessary for ensuring sufficient umbilical perfusion. We report the case of a 33-year-old female undergoing cesarean section in the 36th week of pregnancy because of a large fetal cervical tumor. The EXIT procedure was performed in order to secure the infant’s airway during delivery. The anesthesiological management and interdisciplinary tasks are discussed in the literature review.
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Kill, C., Gebhardt, B., Schmidt, S. et al. Die EXIT-Prozedur als anästhesiologische Herausforderung. Anaesthesist 54, 1105–1110 (2005). https://doi.org/10.1007/s00101-005-0898-y
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DOI: https://doi.org/10.1007/s00101-005-0898-y