Perinatal Outcome of Patients Undergoing Ex-Utero Intrapartum Therapy at the Fetal Therapy Units of Two Reference Centers in Bogota, Colombia

Abstract

Objective: To determine clinical characteristics in newborns with pulmonary or extra-pulmonary disease who undergo successful EXIT procedures at the Fetal Therapy Units of two reference centers in Bogota, Colombia. Methodology: Descriptive case series study. Cases were defined as singleton pregnancies, with pulmonary or extra-pulmonary pathologies which caused obstruction in the fetal airway. Results: Between 2006 and 2016, 54 patients underwent EXIT procedures. Results from prenatal diagnostic testing revealed the following: 27 patients (50%) were diagnosed with diaphragmatic hernias, 15 patients (28%) with cystic adenomatous malformation, four patients (7.4%) with hydrothorax, three patients (5.5%) with bronchopulmonary sequestrations, three patients (5.5%) with cervical masses, one patient (1.8%) with micrognathia, and one patient (1.8%) with a Bronchogenic Cyst (QB). The average gestational age during the EXIT procedures was 37.2 ± 2.54 weeks (range 27-40 weeks). During ultrasound monitoring, 39 (61.1%) cases of fetal complications were reported, eight (14.8%) maternal complications during pregnancy, and seven (13%) maternal surgical complications during the EXIT procedure. Average time of EXIT procedures was 10.8 ± 5.29 minutes (range 5-40 minutes) with an average hospital stay of 9.1 ± 8.5 days (range 1-39 days). The neonatal mortality rate was 60.3% (32/53 patients). Conclusion: The EXIT procedure guarantees an effective transition into the postnatal environment, considerably increasing the chances of survival for the fetus by re-treating a potential emergency into a controlled state.