EXIT means Ex Utero Intrapartum Treatment.

It is a planned specialized Cesarean delivery in which the baby is partly delivered but remains attached to the placenta through the umbilical cord. Placental blood flow and oxygenation are maintained temporarily while a fetal-surgery, neonatal, anesthesia, and airway team performs an urgent intervention before the cord is clamped.

In the context of congenital diaphragmatic hernia (CDH), EXIT was originally used to remove a tracheal clip or balloon placed during fetal tracheal occlusion therapy, then secure the airway by intubation. In selected severe cases it can also support transition to ECMO before separation from the placenta. The procedure is more commonly used for an anticipated obstructed airway, such as a large neck mass or congenital high airway obstruction. EXIT review describes its principle and indications.

Important correction to the note: a lung-to-head ratio (LHR) below 1 signals severe pulmonary hypoplasia and poorer prognosis in CDH, but LHR <1 alone is not automatically an indication for EXIT. EXIT is considered when a tracheal-occlusion balloon must be removed at delivery or when airway/ECMO support is specifically anticipated by a fetal therapy center.

It is a high-risk, highly planned procedure because the mother requires deep uterine relaxation and may have increased bleeding risk.