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CHAOS.

Aman Gupta1, Chandrajeet Yadav2, Sandeep Dhruw2

  • 1Department of Radiodiagnosis, Sri Aurobindo Medical College and PG Institute, Indore, MP India ; 201, Dilpasand Avenue, 5/2, Manorama ganj, Indore, MP 452001 India.

Journal of Obstetrics and Gynaecology of India
|June 15, 2016
PubMed
Summary
This summary is machine-generated.

Congenital high airway obstruction syndrome (CHAOS) causes fetal airway blockage, leading to enlarged lungs and diaphragm abnormalities. Early diagnosis and management are crucial for survival, as associated conditions worsen prognosis.

Keywords:
AntenatalLaryngeal atresiaSonography

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Area of Science:

  • Perinatology
  • Fetal Medicine
  • Pediatric Surgery

Background:

  • Congenital high airway obstruction syndrome (CHAOS) is a rare and often fatal fetal condition.
  • It stems from intrinsic obstruction of the fetal airway, commonly laryngeal atresia.
  • Other causes include tracheal webs, cysts, stenosis, atresia, or agenesis.

Purpose of the Study:

  • To describe the characteristic sonographic findings of CHAOS.
  • To explain the pathophysiology of lung and diaphragm changes in CHAOS.
  • To discuss the prognostic implications of CHAOS, including associated anomalies and hydrops.

Main Methods:

  • Review of sonographic findings in fetuses diagnosed with upper airway obstruction.
  • Correlation of sonographic findings with the underlying pathophysiology of airway obstruction.
  • Analysis of fetal outcomes based on the presence of hydrops and associated anomalies.

Main Results:

  • Sonography reveals symmetrically enlarged, echogenic fetal lungs with a flattened or inverted diaphragm.
  • The fetal heart is often displaced anteriorly and appears small due to lung enlargement.
  • Retained lung fluid due to airway obstruction causes lung distension and characteristic sonographic appearances.

Conclusions:

  • CHAOS is caused by intrinsic upper airway obstruction, preventing normal fetal lung fluid efflux.
  • This leads to fluid accumulation, lung distension, and secondary changes like diaphragm inversion.
  • Prognosis varies; isolated obstruction is more favorable than CHAOS with hydrops or anomalies, which carries a high mortality risk.