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Ex Utero Intrapartum Treatment (EXIT)

Certain lung and airway problems can affect a baby’s ability to breathe immediately following delivery. These babies may need a life-saving procedure called ex utero intrapartum treatment (EXIT) to aid breathing.

High-risk pregnancy doctors at the Fetal Care Center work with specialists at St. Louis Children’s Hospital to identify and treat babies who need EXIT.

Ex Utero Intrapartum Treatment (EXIT): What to Expect

EXIT is similar to a cesarean section (C-section) and takes place on the day you deliver your baby.

This complex procedure requires an innovative approach to anesthesia to protect your health and the health of your baby. Our team includes St. Louis Children’s Hospital pediatric anesthesiologists and Barnes-Jewish Hospital anesthesiologists who ensure proper sedation for babies undergoing EXIT.

During this procedure, the surgical team:

  1. Sedates you with general anesthesia so you are asleep during the procedure
  2. Makes an incision in your lower abdomen
  3. Delivers just the head and neck of your baby, leaving your baby attached to the umbilical cord and placenta, which provide oxygen
  4. Performs one of the following procedures depending on your baby’s specific health problem:
    • Inserts a breathing tube through your baby’s mouth
    • Performs surgery to insert a breathing tube directly into your baby’s airway (trachea)
    • Prepares your baby for surgery directly from the delivery room or for a mechanical heart-lung support system called extracorporeal membrane oxygenation (ECMO)
  5. Delivers your baby and cuts the umbilical cord

Fetal Conditions that May Require EXIT

Specialists at the Fetal Care Center use the most advanced diagnostic technology to detect lung, airway and heart problems in unborn babies. Fetal conditions that may require EXIT include:

  • Neck or airway mass: A blockage in the upper or lower airway
  • Congenital high airway obstruction syndrome: A blockage of the windpipe (trachea) or voice box (larynx)
  • Congenital pulmonary airway malformation: Abnormal lung development

After Ex Utero Intrapartum Treatment (EXIT)

After delivery, your baby receives specialized care in our newborn intensive care unit (NICU), which is connected to labor and delivery. You are never far from your baby.

Babies who need help breathing and do not require ECMO may be placed on a ventilator. If needed, a pediatric surgeon may also perform surgery to correct your baby’s specific health condition.

Contact Us

To make an appointment with a Washington University fetal care specialist at the Women & Infants Center, call 855.925.0631.