Ex-utero Intrapartum Treatment (EXIT)

Ex-utero intrapartum treatment, or the “EXIT Procedure,” is a specialized fetal surgery operation that occurs at the time of birth for certain fetuses with rare conditions predicted to have problems immediately after birth. This procedure is performed similarly to other fetal surgical operations under general anesthesia. The mother’s abdomen and uterus are opened.

The fetus’ head is then delivered, and steps are taken to stabilize the baby prior to delivery. We recommend this procedure for fetuses with conditions expected to present with severe respiratory or breathing problems immediately after birth.

The EXIT Procedure is performed as close to the usual time of birth (term) as possible. The procedure is performed similar to other fetal surgical operations. Under general anesthesia, the mother’s abdomen and uterus will be opened in a specialized manner. The baby’s head and part of the upper body will be delivered, but the baby will stay attached to the umbilical cord and placenta in order to continue receiving life-sustaining oxygen. Steps will then be taken to stabilize the fetus in order to smooth the transition from fetal to postnatal life.

The EXIT procedure may be recommended for fetuses with giant neck masses who have evidence of airway blockage. Additionally, this procedure may be offered in rare situations where fetuses have large lung masses, diaphragmatic hernia, heart problems or other conditions that might cause impairments in fetal heart and lung function.

The EXIT procedure is associated with higher risk than standard C-section delivery. These risks need to be carefully balanced with the potential benefits of the procedure for each case. The team at the Texas Children’s Fetal Center has helped to pioneer the use of the EXIT procedure for the treatment of many fetal conditions and has a track record of proven results.

During your evaluation, your doctors at the Texas Children’s Fetal Center will provide a detailed review of your baby’s condition and treatment options in order to help you and your family decide what the best delivery plan may be.