VP10.12: Prenatal sonographic diagnosis of congenital high airway obstruction syndrome

Abstract

A 28-year-old multiparous (gravida 3) woman at 21 weeks' gestation with previous uneventful pregnancies from a non-consanguineous partner, neither having a family history of the remarkable syndrome among first degree relatives, was referred to BACC for prenatal ultrasound screening of fetal anomaly in November of 2017. On ultrasound examination, fetal lungs were highly echogenic and markedly enlarged while the heart was compressed and the diaphragm was inverted (a, b). In addition, there were fetal ascites and oligohydramnios (c). No other anomalies were identified. The possible uncomplimentary consequence of the pregnancy was discussed with the parents. The pregnancy was terminated at the appeal of the parents. Differences between laryngeal and tracheal atresia are not feasible on ultrasound examination. Congenital high airway obstruction syndrome (CHAOS) can be diagnosed as early as in 15 weeks of gestation with transvaginal ultrasound even before the development of ascites. Treatment option for the fetuses with CHAOS includes prenatal percutaneous fetoscopic and ultrasound-guided tracheal decompression and postnatal ex utero intrapartum treatment with tracheal intubation and safe airway control. In the present case, the constellation of findings pointed towards the diagnosis of CHAOS. Chromosome analysis and supportive intervention could not be attempted due to unavailability. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.