EXIT procedure

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The EXIT procedure, or ex utero intrapartum treatment procedure, is a specialized surgical delivery procedure used to deliver babies who have airway compression due to bronchopulmonary sequestration, congenital cystic adenomatoid malformation, cervical teratoma, or other congenital disorder. The EXIT is an extention of a routine C-section (Cesarean section), where an opening is made in the anesthesticized mother's abdomen and uterus. Then comes the EXIT: the baby is partially delivered through the opening but remains attached to the umbilical cord and the placenta, while a pediatric or neonatal general surgeon establishes an airway so the fetus can breathe. Once the EXIT is complete, the umbilical cord is cut and clamped, and the infant is fully delivered. Then the remainder of the C-section proceeds. The EXIT is much more complex than a routine C-section, as it requires careful coordination between the mother's doctors and the specialists operating on the newborn baby. The difficulty lies in preserving enough blood flow through the umbilical cord, protecting the placenta, and avoiding contractions of the uterus so that there is sufficient time to establish the airway.