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Author Spotlight: Integrating 2D-HPLC-MS and Molecular Networking in Natural Medicine Analysis
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Medicine and the Law

C J M Stewart1, S Peer2, A Numanoglu3

  • 1Department of Obstetrics and Gynaecology, University of Cape Town, and Groote Schuur Hospital, Cape Town, South Africa. Chantal.Stewart@westerncape.gov.za.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|December 6, 2022
PubMed

Congenital high airway obstruction syndrome (CHAOS) is a rare condition that can be diagnosed antenatally by ultrasound. It is usually lethal without immediate intervention at delivery. A 24-year-old woman was diagnosed with fetal CHAOS at 27 weeks' gestation. The couple declined termination of pregnancy. A multidisciplinary team including obstetricians, geneticists, paediatric surgeons, neonatologists and anaesthetists was constituted to plan an ex utero intrapartum treatment (EXIT) procedure. After several simulations, a caesarean section was performed at 38 weeks' gestation under deep inhalational anaesthesia. The fetus was fully delivered with placenta remaining in utero to maintain perfusion. A surgical airway was established via tracheostomy in approximately 5 minutes. The operation was then completed with no maternal complications. The child remains well at 3 years of age. To our knowledge, this is the first EXIT procedure performed for CHAOS in the public sector. This procedure can be lifesaving and is possible with proper planning.

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