CHAOS: A fetal autopsy report.

Area of Science:

• Medical Genetics
• Fetal Medicine
• Pediatric Surgery

Background:

• Congenital high airway obstruction syndrome (CHAOS) is a rare condition caused by incomplete recanalization of the fetal upper airway.
• Common etiologies include laryngeal atresia, tracheal atresia, laryngeal/tracheal webs, subglottic stenosis, cysts, or agenesis.
• Airway obstruction leads to fluid buildup, increased lung pressure, and secondary lung growth.

Observation:

• Fetal lung hyperexpansion compresses the heart, elevating intrathoracic pressure.
• This results in decreased venous return and fetal cardiac failure.
• Secondary effects include ascites, placentomegaly, and hydrops fetalis.

Findings:

• This case details the antenatal diagnosis of a fetus with CHAOS.
• The diagnosis was confirmed through fetal autopsy.
• CHAOS presents a spectrum of severe fetal anomalies.

Implications:

• Early antenatal diagnosis of CHAOS is crucial for timely intervention planning.
• Understanding the pathophysiology aids in managing affected pregnancies.
• Fetal autopsy provides definitive confirmation and aids in genetic counseling.