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[先天性高气道梗阻综合征(CHAOS)胎儿的诊断与管理]

[Diagnosis and management of a foetus with congenital high airway obstruction syndrome (CHAOS)].

作者信息

Jaminet Camille, Leonard Francoise, Devlieger Roland, Chantraine Frederic

机构信息

Service de Gynécologie-Obstétrique, CHC Sainte- Elisabeth, Heusy, Belgique.

Département de Médecine fœtale et maternelle, KU Leuven, Belgique.

出版信息

Rev Med Liege. 2023 Feb;78(2):74-78.

Abstract

Congenital high airway obstruction syndrome is a rare malformation whose prognosis is very poor resulting in foetal or perinatal death if no perinatal intervention is performed. However, ultrasound and magnetic resonance enable an accurate prenatal diagnosis and optimal choice of interventional foetal medicine techniques (transtracheal puncture, fetoscopy). These approaches reduce foetal side effects related to the pathological process, and avoid the mother ex utero intrapartal treatment and its deleterious effects. If it becomes indispensable ex utero intrapartal treatment allows optimal management of the new born by securing the foetal airways while minimizing risk for hypoxic damage through the maintenance of maternal-foetal circulation. We present the story of a couple with a suspected case of CHAOS at 21 weeks of amenorrhea, the diagnostic and the management until the birth of the child.

摘要

先天性高气道梗阻综合征是一种罕见的畸形,其预后非常差,如果不进行围产期干预,会导致胎儿或围产期死亡。然而,超声和磁共振成像能够进行准确的产前诊断,并为胎儿介入性医学技术(经气管穿刺、胎儿镜检查)提供最佳选择。这些方法可减少与病理过程相关的胎儿副作用,并避免母亲体外产时治疗及其有害影响。如果体外产时治疗变得不可或缺,那么通过确保胎儿气道,同时通过维持母婴循环将缺氧损伤风险降至最低,可实现对新生儿的最佳管理。我们讲述了一对夫妇的故事,他们在停经21周时疑似患有先天性高气道梗阻综合征,以及直至孩子出生的诊断和治疗过程。

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