Antenatal Diagnosis of Congenital High Airway Obstruction (CHAOS)
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 3
Abstract
Congenital High Airway Obstruction is a rare and life-threatening condition which occurs due to obstruction of upper airways in the fetus. Ultrasonography is the modality of choice to diagnose this condition, characteristic features being enlarged echogenic lungs, compressed cardia occupying central axis, fetal ascites, inverted diaphragm and dilated airways. We discuss the ultrasonography features of this condition, differential diagnosis, the role of Magnetic resonance Imaging and available treatment options in such condition in this case report. Case Report A 26-year-old women Gravida 3, Para 2, L2 A0 was referred for an anomaly scan at 19weeks. Scan performed outside had commented on fetal ascites and patient came for anomaly scan. There was no history of consanguinity. Family history from both sides was unremarkable. Ultrasonography demonstrated bilateral echogenic lungs, centrally located compressed heart, fetal ascites, dilated trachea and inverted diaphragm. There was no abdominal wall edema, amniotic fluid was normal and other systems were unremarkable. Based on these findings a diagnosis of CHAOS was made and the patient was explained regarding the prognosis of the pregnancy. She decided to continue her pregnancy and around 32 weeks there was fetal demise.Patient refused for autopsy. Introduction CHAOS (Congenital high airway obstruction) is a life-threatening condition, which occurs due to congenital obstruction of fetal airway due to tracheal or laryngeal atresia1. This condition was first observed by Hendrick in 19942. The incidence of this condition is unknown, but if this condition is undiagnosed antenatally it progresses to stillbirth or death after delivery3. Most of the cases are diagnosed antenatally due to improvements in imaging2. Classical antenatal findings include bilateral enlarged hyperechogenic lungs, inverted diaphragm, dilated airways, fetal ascites and non-immune hydrops3.
Authors and Affiliations
Dr Muralidhar G. Kamalapur
Keywords
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