Hedrick M H, Ferro M M, Filly R A, Flake A W, Harrison M R, Adzick N S
Fetal Treatment Center, University of California, San Francisco 94143-0570.
J Pediatr Surg. 1994 Feb;29(2):271-4. doi: 10.1016/0022-3468(94)90331-x.
Congenital high airway obstruction syndrome (CHAOS) results in a predictable constellation of findings: large echogenic lungs, flattened or inverted diaphragms, dilated airways distal to the obstruction, and fetal ascites and/or hydrops. The authors report on four fetuses referred for evaluation. None of them survived. Postmortem evaluation showed that three fetuses had laryngeal atresia, and one had tracheal stenosis. Coexistent fetal anomalies were accurately diagnosed by ultrasound in three of the four patients. The finding of CHAOS on prenatal ultrasound examination is diagnostic of complete or near-complete obstruction of the fetal upper airway, most likely caused by laryngeal atresia. A greater understanding of the natural history of CHAOS may permit improved prenatal and perinatal management.
先天性高气道梗阻综合征（CHAOS）会导致一系列可预测的表现：肺回声增强、膈肌扁平或倒置、梗阻远端气道扩张以及胎儿腹水和/或水肿。作者报告了4例接受评估的胎儿。无一存活。尸检显示，3例胎儿有喉闭锁，1例有气管狭窄。4例患者中有3例通过超声准确诊断出并存的胎儿异常。产前超声检查发现CHAOS可诊断胎儿上气道完全或近乎完全梗阻，最可能由喉闭锁引起。对CHAOS自然病史的更深入了解可能有助于改善产前和围产期管理。
