Lazar et al developed a model for identifying a fetus with a neck mass who was at risk for a complicated airway at birth. A fetus at risk may need to undergo an ex utero intrapartum treatment (EXIT). The authors are from Baylor College of Medicine in Houston.
Parameters:
(1) volume of amniotic fluid
(2) diagnosis of neck mass
(3) tracehoesophageal displacement index (TEDI), which correlates with the largest diameter of the neck mass
The tracheoesophageal displacment is based on measurements in an MRI cross-section of the neck. The location of the tracheoesophageal complex (TEC) is described relative to the ventral edge of the vertebral body.
TEDI =
= (lateral displacement of the TEC in mm) + (ventral displacement of the TEC from anterior edge of vertebral body in mm)
Parameter |
Finding |
Points |
volume of amniotic fluid |
not polyhydramnios |
0 |
|
polyhydramnios |
1 |
diagnosis |
not teratoma |
0 |
|
teratoma |
1 |
TDI |
<= 12 |
0 |
|
> 12 |
1 |
score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 1 was predictive of a complicated airway at birth.
Specialty: Obstetrics & Gynecology, Pedatrics
ICD-10: ,