Decision-making and operative considerations for Ex-utero Intrapartum treatment (EXIT).
Document Type
Article
Publication Date
9-2025
Identifier
DOI: 10.1016/j.bpobgyn.2025.102649
Abstract
The Ex-Utero Intrapartum Treatment (EXIT) is a method of delivery utilized in the setting of fetal anomalies that can lead to respiratory or cardiovascular compromise with the transition to extrauterine life. With multidisciplinary collaboration, delivery occurs with uterine relaxation to preserve placental function, allowing for appropriate intervention while the maternofetal interface is maintained. Multiple types of EXIT procedures are described in the literature that differ based on fetal indication and specific clinical goals. These include EXIT-to-airway, EXIT-to-resection, EXIT-to-extracorporeal membrane oxygenation (ECMO), and EXIT-to-ventricular pacing. When considering an EXIT procedure, fetal benefit must be weighed against maternal risk, and patients require thorough counseling to make an informed decision. In many cases, an individualized approach is necessary. The goal of this review is to provide an overview of the prenatal evaluation, risk stratification, and technical planning necessary for the various forms of EXIT procedures.
Journal Title
Best practice & research. Clinical obstetrics & gynaecology
Volume
102
First Page
102649
Last Page
102649
MeSH Keywords
Humans; Pregnancy; Female; Clinical Decision-Making; Extracorporeal Membrane Oxygenation; Decision Making
PubMed ID
40769046
Keywords
EXIT; EXIT-To-ECMO; EXIT-To-airway; EXIT-To-resection; Ex-utero intrapartum treatment
Recommended Citation
Infusino S, Sajankila N, Nuttall E, Cass DL, Puricelli M, Lobeck IN. Decision-making and operative considerations for Ex-utero Intrapartum treatment (EXIT). Best Pract Res Clin Obstet Gynaecol. 2025;102:102649. doi:10.1016/j.bpobgyn.2025.102649
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