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Vol. 17, No. 5, 2002
Issue release date: September–October 2002
Section title: Paper
Fetal Diagn Ther 2002;17:272–276
(DOI:10.1159/000063179)

Successful Fetal Intervention for Congenital High Airway Obstruction Syndrome

Paek B.W. · Callen P.W. · Kitterman J. · Feldstein V.A. · Farrell J. · Harrison M.R. · Albanese C.T.
aDepartment of Surgery, Division of Pediatric Surgery, bDepartment of Radiology, and cDepartment of Pediatrics, Fetal Treatment Center, University of California, San Francisco, Calif., USA

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Article / Publication Details

First-Page Preview
Abstract of Paper

Received: 9/26/2001
Accepted: 10/4/2001
Published online: 8/12/2002

Number of Print Pages: 5
Number of Figures: 4
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT

Abstract

Introduction: Complete congenital high airway obstruction syndrome (CHAOS) usually leads to stillbirth or death within minutes of delivery. We describe the management and long-term follow-up of a baby with a prenatally diagnosed airway obstruction. Case: Because of progressive hydrops fetalis, massive ascites and everted diaphragms due to CHAOS in a fetus at 24 weeks of gestation, a fetal tracheostomy was performed. Persistent fetal bradycardia at the time of the fetal procedure led to delivery of the infant. Adequate oxygenation and ventilation were attained using relatively low oxygen concentrations and low ventilatory pressures. Plain radiographs demonstrated that the lungs were large and the ribs thin. The infant has a permanent tracheostomy, required continuous assisted ventilation for several months and assisted ventilation at night at home for 3 years. At 4 years of age, he has no speech, all feedings are by gastrostomy, and developmentally he is mildly to moderately delayed. Conclusion: Laryngeal atresia produced over-distended lungs and hydrops. Precise prenatal imaging and fetal surgical strategies may allow the survival of affected fetuses.


  

Author Contacts

Craig T. Albanese, MD
Fetal Treatment Center, University of California, San Fancisco
513 Parnassus Avenue, Room HSW 1601
San Francisco, CA 94143-0570 (USA)
Tel. +1 415 475 2479, Fax +1 415 476 2314, E-Mail albanesec@surgery.ucsf.edu

  

Article Information

Received: Received: October 4, 2000
Accepted: September 26, 2001
Number of Print Pages : 5
Number of Figures : 4, Number of Tables : 1, Number of References : 15

  

Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)
Formerly ‘Fetal Therapy’
Official Organ of the ‘International Fetal Medicine, Surgery Society’ and the International Society ‘Fetus as a Patient’

Vol. 17, No. 5, Year 2002 (Cover Date: September-October 2002)

Journal Editor: W. Holzgreve, Basel
ISSN: 1015–3837 (print), 1421–9964 (Online)

For additional information: http://www.karger.com/journals/fdt


Article / Publication Details

First-Page Preview
Abstract of Paper

Received: 9/26/2001
Accepted: 10/4/2001
Published online: 8/12/2002

Number of Print Pages: 5
Number of Figures: 4
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: http://www.karger.com/FDT


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