Prenatal detection of congenital high airway obstruction syn
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Congenital high airway obstruction syndrome (CHAOS) is defined as complete or partial obstruction of the fetal upper airways. The cause may be laryngeal atresia, tracheal atresia, or laryngeal cyst, but the clinical presentation is the same. Due to advances in antenatal imaging, more cases are being detected in the prenatal period. CHAOS can occur in isolation or can be syndromic. The association of CHAOS with encephalocele and limb anomalies has been reported in two cases.[1] Both these cases had an anterior encephalocele. Here we report a case of CHAOS with occipital encephalocele.

Case Report
A 23-year-old primigravida was referred to us for evaluation of fetal anomaly, occipital encephalocele, at 23 weeks of gestation. It was a spontaneous conception. She was married for 6 months, it was a non-consanguineous marriage. USG done showed a single fetus with parameters corresponding to 22 weeks of gestation with an occipital encephalocele. The lungs were enlarged and echogenic with everted diaphragm. High airways were dilated and the division of the trachea was seen. The heart was centrally placed and compressed. There was cutaneous edema and hydramnios. The stomach shadow was not visualized. The fetal karyotype was normal. The couple was counseled regarding the poor prognosis.

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