In our “Life Pioneers” series, The Daily Signal reported on the miracle of fixing birth defects before birth—a lifesaving technique known as fetal surgery.
In the case of Elijah Leffingwell, the subject of a profile in the series, at 25 weeks gestation, he was partially removed from his mother’s womb so surgeons could remove a tumor the size of an orange from his left lung.
He went back inside the womb until he was born prematurely at 33 weeks.
>>> Elijah’s Story: A Life Saved Before Birth
Sometimes, a baby’s condition requires a special surgical procedure performed while a baby is partially being born.
In these rare cases, doctors use a specialized surgical delivery method called the EXIT procedure (ex utero intrapartum treatment) to deliver babies suffering from airway compression.
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An EXIT procedure is done in anticipation that the baby will have an immediate, critical problem once separated from the mother at delivery.
Since 1995, the Children’s Hospital of Philadelphia, which has done more of these procedures than anywhere in the world, has only performed about 100 EXITs, for conditions such as cervical teratoma, cystic hygroma or congenital high airway obstruction syndrome (CHAOS).
A baby that has already had fetal surgery while still in its mother’s womb does not require an EXIT procedure.
>>> ‘The Innocent Bystander’: A Mother’s Struggle After a Miracle Birth
The EXIT, considered similar to a standard Caesarean section, but also notably different, works like this:
Unlike a normal C-Section, the mother receives anesthesia and falls asleep. Doctors open the uterus and partially deliver the baby (out to the belly button) through the incision, while the baby remains attached to the placenta.
The attachment to the placenta—serving as a lifeline—ensures the baby will continue to get oxygen and nutrients from its mother while surgeons establish an airway that will allow the baby to breathe on its own.
Once the EXIT is complete, the umbilical cord is clamped then cut and the infant is fully delivered, with the rest of the process unfolding like a normal C-section delivery.
While an EXIT procedure can include the risk of uterine bleeding and is considered much more complex and challenging than a standard C-section, the technique can provide yet another chance at life for a baby once doomed to death.
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