{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T16:41:04Z","timestamp":1772728864141,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The ex utero intrapartum treatment (EXIT) is utilized to transition fetuses with prenatally diagnosed airway obstruction to postnatal life. We describe the unique clinical course, diagnosis, treatment, and outcomes of patients with cervical lymphatic malformation (CLM) managed with EXIT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of fetuses with diagnosed CLM was delivered by EXIT (2001\u20102018) in a tertiary referral fetal center. Outcomes included survival, tracheostomy at discharge, neonatal course after delivery, and pulmonary hypoplasia. Data are reported as median [range] and rate (%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 45 patients delivered by EXIT, 10 were delivered for CLM: seven had polyhydramnios, one had nonimmune hydrops, five delivered preterm, and three were emergency EXITs. The EXIT time and estimated blood loss were 125\u00a0minutes (95, 158) and 900\u00a0mL (500, 1500), respectively. Airway was secured in all. There was one neonatal death (day 8) with prematurity, sepsis, and pulmonary hypoplasia. Three out of nine were discharged with a tracheostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In CLM, close monitoring for structural neck involvement and development of polyhydramnios are important and may be an indication for EXIT as the optimal delivery mode. An experienced multidisciplinary team is a key factor for an effective approach to the obstructed airway in CLM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5428","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T20:10:42Z","timestamp":1549051842000},"page":"287-292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Cervical lymphatic malformations: Prenatal characteristics and ex utero intrapartum treatment"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6333-3177","authenticated-orcid":false,"given":"Alireza A.","family":"Shamshirsaz","sequence":"first","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey A.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1655-6877","authenticated-orcid":false,"given":"Hadi","family":"Erfani","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed A.","family":"Nassr","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"},{"name":"Department of Obstetrics and Gynecology Women's Health Hospital, Assiut University  Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan C.","family":"Sundgren","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy R.","family":"Mehollin\u2010Ray","sequence":"additional","affiliation":[{"name":"Department of Radiology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-0934","authenticated-orcid":false,"given":"Shaine A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimmy","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-9859","authenticated-orcid":false,"given":"Magdalena","family":"Sanz Cortes","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Cassady","sequence":"additional","affiliation":[{"name":"Department of Radiology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eumenia C.","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Pathology &amp; Immunology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olutoyin A.","family":"Olutoye","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak K.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrell","family":"Cass","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Cleveland Clinic Foundation  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluyinka O.","family":"Olutoye","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Belfort","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology Baylor College of Medicine and Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890050065012"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70285-0"},{"key":"e_1_2_9_4_1","first-page":"163","volume-title":"Operative Obstetrics","author":"Shamshirsaz AA","year":"2016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2006.02.008"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.10.022"},{"issue":"2","key":"e_1_2_9_7_1","first-page":"87","article-title":"MR imaging and ultrasound of fetal cervical cystic lymphangioma: utility in antepartum treatment planning","volume":"11","author":"Teksam M","year":"2005","journal-title":"Diagn Interv Radioly (Ankara, Turkey)"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpradiol.2013.12.001"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.01201.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31821b173e"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e3283531b51"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.03.024"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14796"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.06.029"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.02.006"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.112249"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.11.024"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.107"},{"key":"e_1_2_9_19_1","unstructured":"FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women: United States Food and Drug Administration.; 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Available from:https:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm532356.htm."},{"key":"e_1_2_9_20_1","article-title":"Fetoscopic laryngo\u2010tracheoscopy: a novel diagnostic modality to avoid unnecessary ex\u2010utero intrapartum treatment (EXIT) in cases with suspected fetal airway compromise","author":"Shamshirsaz AA","year":"2018","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpd.5428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.5428","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.5428","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.5428","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T05:13:42Z","timestamp":1694409222000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.5428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1002\/pd.5428"],"URL":"https:\/\/doi.org\/10.1002\/pd.5428","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]},"assertion":[{"value":"2018-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}