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 challenge 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 lack of specialized care in Cyprus, he advised the couple to come to Israel for delivery, where advanced multidisciplinary teams could prepare for the complex case.

In Israel, at Beilinson Hospital in Petah Tikva, Dr. Yuval Gielchinsky, head of the fetal medicine center and a student of Nicolaides, coordinated care with teams from Schneider Children's Medical Center. Despite the ongoing war with Iran and frequent air raid sirens, the couple arrived at 34 weeks gestation and awaited the birth. The cyst had refilled and nearly filled the entire oral cavity, posing a severe risk of airway obstruction at birth.

The medical teams planned for a rare EXIT procedure, which maintains placental oxygenation during cesarean delivery to secure the newborn's airway. However, to avoid this high-risk surgery, Dr. Gielchinsky performed an unprecedented prenatal intervention: under ultrasound guidance, he inserted a needle through the uterine wall to drain the cyst while the baby was still in the womb. This decompression opened the airway, allowing the baby to breathe independently immediately after birth without emergency intervention.

Following delivery, the newborn was monitored in the neonatal intensive care unit and treated by ENT and oral surgery specialists. The cyst had shrunk significantly, though a small remnant remained, with plans for further surgery. After two weeks, the family returned to Cyprus with their healthy baby. Dr. Gielchinsky emphasized that early detection through routine anatomy scans was crucial, enabling life-saving prenatal treatment and careful birth planning. Dr. Roy Hod from Schneider highlighted the importance of the multidisciplinary approach and the rare EXIT procedure as a backup plan.

This case demonstrates the critical role of advanced prenatal diagnostics and international medical collaboration, even amid geopolitical conflict, in saving lives and preventing neonatal airway emergencies.