Anesthésie et recherche clinique
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From ‘OOPS to EXIT’: A Review of the Origins and Progression of Ex Utero Intrapartum Treatment

Nwamaka Nnamani

Advancement in the safety of obstetric anesthesiology has largely been due to better pharmacotherapy, monitoring devices and airway adjuncts. Similarly, the rate of fetal mortality has declined in the last two decades particularly due to improved neonatal intensive care and the wide-spread use of surfactant for premature births. The field of perinatology has long recognized that certain high-risk fetal anomalies, which previously carried significant mortality rates may now be amenable to the Ex Utero Intrapartum Treatment (EXIT). This review discusses the history of EXIT and focuses on the role of the anesthesiologist during this procedure; with emphasis that the successful outcome of many EXIT procedures is a testament to the advancements in obstetric anesthesiology, our understanding of maternal and fetal physiology, safer anesthetic agents, and improved overall safety of general anesthesia in parturients.