Purpose or Case Report: Congenital high airways obstruction sequence (CHAOS) refers to a relatively rare fetal anomaly caused by high airway obstruction (tracheal or laryngeal) caused by atresia or stenosis. Similar imaging findings can be seen with airway obstruction due to oropharyngeal or neck masses such as teratoma. Antenatal imagining findings include but not limited to dilated fluid filled trachea and proximal bronchi, bilateral enlarged echogenic lungs with relative small sized midline heart, flattening or eversion of the diaphragm, feta ascites and anasarca and polyhydramnios. The prognosis is overall poor, however it is improved after planning for delivery and performing EXIT procedure (ex utero intrapartum treatment) with tracheostomy.
We present a case of a 20-year-old female G1P0 at 25 weeks of gestation diagnosed with Congenital high airways obstruction sequence (CHAOS) with typical features on prenatal ultrasound and fetal MR. Delivery was planned and an EXIT procedure was performed and the newborn survived.
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Conclusions: Congenital high airways obstruction sequence (CHAOS) is a rare fetal anomaly with characteristic antenatal ultrasound and MR features that are important to identify for adequate delivery planning.