Features of providingspecialized multidisciplinary care for a newborn with congenital oral tumor and risk of asphyxia diagnosed prenatally, using fetal intervention (clinical case)

Abstract

Congenital granular cell phase or congenital epulis (granular cell myoblastoma, Neumann's end) is a rare benign soft tissue lesion in newborns. Most often, this lesion occurs in isolation, it may not be associated with the congenital absence of the tooth germ in the area of its eruption. It is associated with perinatal complications. The size of the lesions is crucial when planning delivery and subsequent treatment, larger advantages in terms of the size of the composition of the oral cavity can cause airway obstruction in the newborn, and difficulties with intubation contribute to prolonged oxygen starvation and, accordingly, be the cause of further adverse consequences.

Aim - to demonstrate the features of prenatal diagnosis, tactics of pregnant women's management, surgical treatment and postoperative observation of a newborn with a congenital position of the oral cavity and the risk of asphyxia, as well as to emphasize the importance of coordinated interaction of specialists in various areas in ensuring the optimal treatment outcome.

A clinical case of providing specialized multidisciplinary care to a newborn with a congenital clinical oral cavity and the risk of asphyxia, diagnosed prenatally using the EXIT (Ex utero Intrapartum Treatment) procedure, is presented. The provision of multidisciplinary care to a newborn with a prenatally diagnosed congenital complete oral cavity and the risk of asphyxia is demonstrated. Namely, preparation for delivery, the use of the EXIT procedure: delivery by cesarean section with the removal of the fetal head into the wound with repeated intubation of the newborn on a pulsating umbilical cord. Further transportation to the neonatal surgery department and surgical intervention with the removal of this formation.

Conclusions. Timely diagnosis and a multidisciplinary approach are the basis for developing patient-oriented tactics for managing a child with congenital malformations and are the key to a favorable prognosis for the newborn. The presence of a large oral tumor with the risk of airway obstruction and asphyxia requires careful planning of delivery with the possibility of using the EXIT procedure with immediate tracheal intubation on a working umbilical cord to ensure minimal risk of damage to the newborn, and accordingly to reduce possible further complications.

The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.