Israeli Medical Teams Save Fetus With Rare Prenatal Procedure Amid War Conditions

A young couple from Cyprus, expecting their first child, faced a critical prenatal diagnosis when a large cyst was discovered blocking their unborn baby's mouth during a 20-week ultrasound. The cyst, filled with fluid and located under the tongue, threatened the baby's ability to breathe immediately after birth. They were referred to Professor Kypros Nicolaides, a leading fetal medicine expert in London, who drained the cyst under ultrasound guidance but warned it would likely refill. Due to the complexity of the case and lack of adequate medical infrastructure in Cyprus, he advised the couple to come to Israel for delivery, where advanced multidisciplinary care was available.

In Israel, at Beilinson Hospital in Petah Tikva, teams from various specialties including neonatology, pediatric surgery, ENT, and anesthesiology prepared for the birth. The couple arrived during a temporary ceasefire amid the ongoing war with Iran, facing repeated air raid sirens while awaiting delivery. Dr. Yuval Gielchinsky, head of the fetal medicine center at Beilinson and a student of Nicolaides, coordinated the care. Upon arrival, the cyst had nearly filled the entire oral cavity, posing a severe risk of airway obstruction at birth.

The medical team planned for an EXIT procedure, a rare cesarean technique that maintains placental oxygenation while securing the baby's airway. However, to avoid the risks of EXIT, Dr. Gielchinsky performed an unprecedented prenatal intervention: under ultrasound guidance, he inserted a needle through the uterine wall to drain the cyst directly while the fetus was still in the womb. This decompression opened the airway, allowing the baby to be born breathing independently without emergency intervention.

After birth, the newborn was monitored in Schneider Children's Medical Center's neonatal intensive care unit and later treated by ENT and oral surgery specialists. The cyst had shrunk significantly, though a small remnant remained, with plans for future surgery. The family returned to Cyprus two weeks later in good condition. Dr. Gielchinsky emphasized that early detection through routine anatomy scans was crucial in enabling this life-saving preparation and intervention. The case highlights the importance of advanced prenatal diagnosis and multidisciplinary collaboration in managing rare fetal anomalies, even under challenging wartime circumstances.