EXIT helps save baby with breathing trouble

Such was the size of the swelling that its swallowing was compromised, and in 36 weeks, breathing was affected.

Following this, doctors at Mehta’s Hospital where the mother, Saradha P (name changed), was being treated performed a procedure called EX-utero Intrapartum Treatment (EXIT) on her, which helped her deliver a healthy baby boy who is breathing without any difficulty.

Stating that the EXIT procedure is used to deliver babies with neck swelling or wherever a difficult airway is anticipated due to a mass in the neck or upper chest, Dr Lakshmi of the neonatal team at Mehta’s Hospital said, “The procedure preserves utero-placental gas exchange. The baby continues to receive oxygen and nutrients from the mother until an airway is established by placing an endotracheal tube and lung is ventilated with satisfactory oxygenation.”

The mother was receiving antenatal care at another clinic where she had an ultrasound for checking the growth of the baby in her 28th week. It was then that the doctors noticed the swelling. The team of experts there undertook a detailed examination, which confirmed that the swelling was an enlargement of the foetal thyroid gland due to hypothyroidism, she added.

At 36 weeks, a foetal MRI was done which showed compression of the airway that would make it difficult for the baby to breathe after delivery. “Anticipating problems in securing airway, the EXIT procedure was planned. A caesarean section was then performed under general anaesthesia, and the baby boy was delivered only up to the head and held in position with the body still in the uterus with intact umbilical cord. An attempt to intubate the airway with a tube to make an air passage for breathing was attempted. Once we secured the airway, we delivered the baby and cut the cord,” she explained.

While the baby needed ventilator support for two days, his swollen gland started shrinking following treatment, and he was taken off the endotracheal tube and ventilation on day three, the doctor said, adding that the baby is now able to breath without any difficulty.