Tracheal occlusion may improve the outlook of fetuses with an antenatal diagnosis of congenital diaphragmatic hernia and is undertaken at around 24 weeks' gestation with planned puncture at around 34 weeks. If preterm labour occurs away from the centre that placed the tracheal occlusion, puncture before delivery may not be possible, but we present a case where emergency delivery by ex utero intrapartum treatment procedure was used to deflate the balloon successfully before full delivery of the baby, leading to survival of the baby. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)