E X I T (ex-utero intrapartum therapy) en linfangioma cervical fetal

Se presenta un caso clinico de una embarazada primigesta de 17 anos, con un feto con gran masa cervical a las 20 semanas, se diagnostica como linfangioma cervical. La evaluacion prenatal concluye que existe gran riesgo de asfixia perinatal por obstruccion de la via aerea superior, se resuelve el parto mediante procedimiento EXIT (ex-utero intrapartum therapy) a las 37 semanas. Se logra realizar intubacion con larin-goscopia directa, con un tiempo de by-pass uteroplacentario de 7 minutos. Se obtiene un recien nacido de 3300 g, al segundo dia se opera del tumor con buenos resultados. Se revisa el protocolo del procedimiento EXIT en sus aspectos anestesicos, obstetricos, quirurgicos y neonatologicos. Se concluye que el EXIT debe ser planteado en todo caso en que se sospeche obstruccion de la via aerea superior y puede ser realizado en hospitales que cuenten con equipamiento habitual y un equipo medico multidisciplinario. 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.