Indian Journal of Anaesthesia  
About us | Editorial board | Search | Ahead of print | Current Issue | Past Issues | Instructions
Home | Login  | Users Online: 122  Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size    


CASE REPORT
Year : 2009  |  Volume : 53  |  Issue : 6  |  Page : 678-682

Congenital Cervical Teratoma: Anaesthetic Management (The EXIT Procedure)


1 Gulhane Military Medical Faculty, Department of Anesthesiology and Reanimation, Emek, Turkey
2 Department of Obstetrics and Gynecology, Emek, Turkey
3 Gulhane Military Medical Faculty, Department of Anesthesiology and Reanimation and Pediatric Surgery, Emek, Turkey

Correspondence Address:
Nedim Cekmen
Nedim cekmen, 72. Sok. 66/4 Emek
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 20640096

Rights and PermissionsRights and Permissions

Ex utero intrapartum treatment (EXIT) is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old woman, 70 kg, 160 cm, gravida 2, para 1, was followed because of polyhydramniosis diagnosed at 24 weeks' gestation. During a routine ultrasonographic examination at 35 weeks' gestation, it was noticed that the fetus had a tumoral mass on the anterior neck, the mass had cystic and calcified components and with a size of was 10 x 6 x5 cm. The patient with physical status ASA I, was submitted to caesarean section under general anaesthesia with mechanically controlled ventilation for exutero intrapartum treatment (EXIT). Anaesthesia was induced in rapid sequence with fentanyl, propofol and rocuronium and was maintained with isoflurane in 2.5 at 3 % in O 2 and N 2 O (50%). After hysterotomy, fetus was partially released assuring uterus-placental circulation, followed by fetal laryngoscopy and tracheal intuba­tion. The infant was intubated with an uncuffed, size 2.5 endotracheal tube. Excision of the mass was performed under general anaesthesia. After surgical intervention, on the fourth postoperative day, the infant was extubated and the newborn was discharged to the pediatric neonatal unit and on the seventh day postoperatively to home without complications. Major recommendations for EXIT are maternal-fetal safety, uterine relaxation to maintain uterine volume and uterus-placental circulation, and fetal immobility to help airway handling. We report one case of cervical teratoma managed successfully with EXIT procedure.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1725    
    Printed98    
    Emailed0    
    PDF Downloaded357    
    Comments [Add]    

Recommend this journal