Successful ex utero intrapartum treatment procedure for prenatally diagnosed severe micrognathia: a case report

J Obstet Gynaecol Res. 2014 Aug;40(8):2005-9. doi: 10.1111/jog.12423.

Abstract

We present a case of fetal severe micrognathia in which successful airway stabilization was achieved by an ex utero intrapartum treatment procedure. In this case, it was anticipated that the infant would have a vulnerable airway at birth based on in utero sonographic findings, including an extremely hypoplastic jaw, worsening polyhydramnios and absence of stomach visualization. Early sonographic recognition was helpful in preparing the parents and physicians for the possibility of airway emergencies during the perinatal period. When a severely hypoplastic mandible accompanied by polyhydramnios and absent stomach visualization is noted on ultrasound, clinicians should consider the indication for ex utero intrapartum treatment. A multidisciplinary team with technically skilled medical providers should be coordinated to perform the procedure.

Keywords: ex utero intrapartum treatment; micrognathia; polyhydramnios; tracheotomy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Airway Obstruction / etiology
  • Airway Obstruction / prevention & control*
  • Cesarean Section*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Intraoperative Care*
  • Japan
  • Micrognathism / diagnostic imaging
  • Micrognathism / embryology
  • Micrognathism / physiopathology
  • Micrognathism / surgery*
  • Perinatal Care*
  • Polyhydramnios / etiology
  • Pregnancy
  • Stomach / diagnostic imaging
  • Stomach / embryology
  • Tracheostomy*
  • Treatment Outcome
  • Ultrasonography, Prenatal