Fetal EXIT Procedure

A fetal EXIT (EX-utero Intrapartum Treatment) procedure is a combination of a traditional Cesarean section delivery and an operation on the baby as it is being born to try to correct a problem which would prevent the baby from living outside the uterus (womb) on its own. An example this would be where the fetus has something blocking the natural airway, such as a tumor, so that at the time of a normal birth the baby would be unable to breath. Without an EXIT procedure to open the airway while the baby is still receiving oxygen from the mother via the umbilical cord and placenta, the baby would probably die at birth.

Because an EXIT procedure requires two full operating teams (surgeons, nurses and anesthesia personnel) working in the same space (the mother’s lower abdomen) in a highly coordinated fashion, the procedure requires a high level of expertise and planning. Added to the risks of a standard Cesarean section and surgery to a sick baby is the risk of additional blood loss to mother from having her uterus "open" while the baby’s surgery is being performed. The baby is also at risk of the placenta separating before the life-saving surgery is completed.

Currently, pediatric sub-specialty physicians from Lurie Children’s (neonatal intensive care, otolaryngology, pediatric surgery and anesthesia), in conjunction with maternal fetal medicine and OB anesthesia specialists at Prentice Women’s Hospital, perform this procedure in carefully selected cases.