International Pediatric Otolaryngology Group (IPOG): Consensus recommendations on the prenatal and perinatal management of anticipated airway obstruction

Michael D. Puricelli*, Reza Rahbar, Gregory C. Allen, Karthik Balakrishnan, Matthew T. Brigger, Sam J. Daniel, Pierre Fayoux, Steven Goudy, Richard Hewitt, Wei Chung Hsu, Jonathan B. Ida, Romaine Johnson, Nicolas Leboulanger, Scott M. Rickert, Soham Roy, John Russell, Michael Rutter, Douglas Sidell, Marlene Soma, Briac ThierryMarilena Trozzi, George Zalzal, Carlton J. Zdanski, Richard J.H. Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: To make recommendations on the identification, routine evaluation, and management of fetuses at risk for airway compromise at delivery. Methods: Recommendations are based on expert opinion by members of the International Pediatric Otolaryngology Group (IPOG). A two-iterative Delphi method questionnaire was distributed to all members of the IPOG and responses recorded. The respondents were given the opportunity to comment on the content and format of the survey, which was modified for the second round. “Consensus” was defined by >80% respondent affirmative responses, “agreement” by 51–80% affirmative responses, and “no agreement” by 50% or less affirmative responses. Results: Recommendations are provided regarding etiologies of perinatal airway obstruction, imaging evaluation, adjunct evaluation, multidisciplinary team and decision factors, micrognathia management, congenital high airway obstruction syndrome management, head and neck mass management, attended delivery procedure, and delivery on placental support procedure. Conclusions: Thorough evaluation and thoughtful decision making are required to optimally balance fetal and maternal risks/benefits.

Original languageEnglish (US)
Article number110281
JournalInternational journal of pediatric otorhinolaryngology
StatePublished - Nov 2020


  • Attended delivery
  • Congenital high airway obstruction syndrome (CHAOS)
  • Delivery on placental support
  • Ex utero intrapartum treatment (EXIT)
  • Fetal head and neck mass
  • Micrognathia
  • Operation on placental support (OOPS)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology


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