The ex utero intrapartum treatment (EXIT) procedure was primarily developed to reverse temporary tracheal occlusion in patients with fetal surgery for congenital diaphragmatic hernia. Nowadays, it is widely used to resect fetal neck masses and to maintain an unobstructed airway. It is indicated for the management of several cardiothoracic diseases, including mediastinal or lung mass resection, drainage of pleural effusions, palliative treatment of critical congenital heart disease and establishment of EXIT-to-extracorporeal membrane oxygenation (ECMO). EXIT has been attempted successfully in many centers, and it has been proven that mothers and babies tolerate the procedure well. Maternal and fetal surveillance during anesthesia is important to maintain maternal blood pressure and placental blood flow and fetal oxygenation. The aim of this article is to discuss the application of the EXIT procedure for the management of fetal cardiothoracic diseases.
Key words: anesthesia, fetus, mediastinal neoplasms, pleural effusion