A BRIEF EXIT BEFORE A GRAND ENTRANCE

摘要

Well-known historian Winston Churchill has been quoted as stating "He who fails to plan, plans to fail." Significant planning and collaboration were necessary to prepare for the first Ex-utero Intrapartum Treatment (EXIT) procedure in the IWK Health Centre in Halifax, NS. EXIT is a life-saving technique used to secure a fetal airway when there is some type of airway compression involved. The procedure is done while oxygenation and perfusion are maintained through utero-placental circulation. The IWK's obstetrical team followed a mother whose fetus was diagnosed in utero with a high airway anomaly/obstruction.The EXIT procedure involved interprofessional collaboration with the following teams: pre-natal care; obstetrics; paediatric and adult anesthesia; otolaryngology; neonatology; respiratory therapy; and the paediatric Operating Room (OR).This article will review the steps taken to prepare for this elective procedure and the measures undertaken in preparation for the possibility of emergency surgery due to early labour. It will also describe the intraoperative experience and the post-operative debriefing session.