Perinatal outcome of fetuses with congenital high airway obstruction syndrome: a single-center experience

Abstract

ObjectiveTo report our experience with management of fetuses with congenital high airway obstruction syndrome (CHAOS). MethodsWe retrospectively reviewed the cases of fetuses who were prenatally diagnosed and postnatally confirmed withCHAOS between 2010 and 2019 at Asan Medical Center, Seoul, Korea. ResultsOf 13 fetuses prenatally diagnosed with CHAOS, 7 were lost to follow-up and 6 were postnatally confirmed as havingCHAOS. All fetuses, except one were delivered via cesarean section with an ex utero intrapartum treatment (EXIT)procedure. Two patients had coexisting congenital heart diseases requiring several cardiac surgeries following birth. Both of these patients demonstrated developmental delay; however, the remaining 4 had a normal developmentexcept for expressive language. Two infants died of respiratory complications, and the remaining 4 were alive at theend of the follow-up period. All 4 live patients underwent tracheostomy with planned reconstruction surgery. Threechildren are now able to phonate, and 1 can maintain a conservation. ConclusionThe proper management of CHAOS using the EXIT procedure results in high survival and low hypoxemia-inducedcomplication rates. Therefore, an accurate prenatal diagnosis is necessary for an appropriate perinatal management.