At 16 weeks of pregnancy, a routine ultrasound revealed a rapidly growing mass on the left side of baby Layla’s neck. Within weeks the tumor had nearly doubled in size, raising serious concerns that it would block her airway at birth.

The mass, later confirmed as a benign teratoma, measured about 17 centimeters — larger than Layla’s head — and weighed nearly two pounds. Without careful planning, a standard delivery could have left her without oxygen for critical minutes, risking severe brain injury or death.

To give her the safest possible start, a multidisciplinary team at the UW Health Fetal Diagnosis and Treatment Center in Madison, Wisconsin, performed a rare EXIT (ex-utero intrapartum treatment) procedure at approximately 32–33 weeks. During the operation, surgeons partially delivered Layla’s head, neck, one arm, and the tumor while she remained attached to her mother via the umbilical cord and placenta. This placental support continued to supply oxygen while the team secured her airway. They successfully placed a breathing tube in just 12 minutes before completing the delivery.

Four days later, doctors removed the tumor entirely. Layla spent about two and a half months in the neonatal intensive care unit due to her prematurity and recovery from surgery. Today she is a healthy, thriving baby with minimal scarring.

Her parents, Ashley and Andy Manderle of Waupun, Wisconsin, have expressed deep gratitude for the specialized fetal care that made the difference. The EXIT procedure, used only in carefully selected cases of airway-threatening fetal masses, allowed the medical team to control a situation that would otherwise have been life-threatening the moment Layla took her first independent breath.

Layla’s case highlights both the advances in prenatal diagnosis and the critical role of coordinated fetal surgery teams in managing rare but high-risk conditions.

Sources

• UW Health / Fox 11, Fox 47, WMTV, and WBAY reports on Layla Manderle (June 2023)
• Statements from pediatric and fetal surgeon Dr. Inna Lobeck and the Manderle family