E X I T (ex-utero intrapartum therapy) en linfangioma cervical fetal / EXIT procedure (ex-utero intra-partum therapy) for fetal neck lymphangioma
Rev. chil. obstet. ginecol
; 78(1): 55-59, 2013. ilus
Article
em Es
| LILACS
| ID: lil-677310
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RESUMEN
Se presenta un caso clínico de una embarazada primigesta de 17 años, con un feto con gran masa cervical a las 20 semanas, se diagnostica como linfangioma cervical. La evaluación prenatal concluye que existe gran riesgo de asfixia perinatal por obstrucción de la vía aérea superior, se resuelve el parto mediante procedimiento EXIT (ex-utero intrapartum therapy) a las 37 semanas. Se logra realizar intubación con larin-goscopia directa, con un tiempo de by-pass uteroplacentario de 7 minutos. Se obtiene un recién nacido de 3300 g, al segundo día se opera del tumor con buenos resultados. Se revisa el protocolo del procedimiento EXIT en sus aspectos anestésicos, obstétricos, quirúrgicos y neonatológicos. Se concluye que el EXIT debe ser planteado en todo caso en que se sospeche obstrucción de la vía aérea superior y puede ser realizado en hospitales que cuenten con equipamiento habitual y un equipo médico multidisciplinario.
ABSTRACT
We report a case of primigravida patient, 17 years old, with a fetus showing a large cervical mass at 20 weeks of gestation and was diagnosed as a cervical lymphangioma. The prenatal evaluation concludes that there exists a great risk of perinatal asphyxia due to obstruction of the upper airway and therefore it is decided to perform a cesarean section at 37 weeks of gestation, using an EXIT procedure (ex-utero intra-partum therapy). We perform intubation with a semi- rigid tube having a by-pass time utero-placental of 7 minutes, obtaining a newborn of 3300 g at birth. The newborn is operated two days after birth removing the cervical tumor with good results. We review the protocol of the EXIT procedure concerning aspects related to anesthesia, obstetrics, surgery and neonatal care. We conclude that EXIT should be considered in all cases in which obstruction of the upper airway is suspected, and can be performed in hospitals that have basic surgical facilities and a multidisciplinary team.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Doenças Fetais
/
Neoplasias de Cabeça e Pescoço
/
Linfangioma
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Limite:
Adolescent
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
Es
Revista:
Rev. chil. obstet. ginecol
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Chile