Chaos syndrome - BJR
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Congenital high airway obstruction syndrome (CHAOS) is the obstruction of the foetal upper airways, which may be partial or complete. It is usually incompatible with life. Prenatal recognition of the disease is quite important. We report here a case of CHAOS diagnosed on antenatal ultrasonography.

Case Report:

A 27-year-old female came to the hospital for routine second trimester antenatal ultrasound. Clinical history did not reveal any predisposition to increased risk for genetic or familial disorder. Initial first-trimester ultrasound scan was done at 6 weeks which did not show any significant abnormality. Then she reported directly at 24 weeks of gestation for follow-up second-trimester foetal anomaly scan. Apart from second-trimester ultrasound, other routine antenatal investigations did not reveal any significant abnormality. The foetal karyotype was normal.

The classical ultrasound signs of “CHAOS” are as follows:
Dilated airways below the level of obstruction, Hyperexpanded and hyperechoic lungs,
Flattened diaphragm. These signs were classically depicted in the foetal ultrasound scan images...

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