Congenital High Airway Obstruction Syndrome Treatment

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In Congenital High Airway Obstruction Syndrome (CHAOS),  fetal upper airways get harmed, in a specific area, or in an entire area. The diaphragm becomes flat and laryngeal cyst is responsible for this.

CHAOS or Congenital High Airway Obstruction Syndrome is an uncommon disorder, which blocks the larynx and trachea of a child. Mostly seen in children which are in their mother’s womb, in CHAOS lungs of a baby becomes very crucial and this is one of the causes of infant death worldwide, according to Centres for Diseases and birth control and prevention. Mostly there are 2 types of CHAOS

1. Laryngeal atresia with tracheo-oesophagal fistula.

2. Laryngeal Atresia without oesophagal fistula.

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Congenital High Airway Obstruction Syndrome Treatment


When the size of the lungs abnormally increases because of the fluid addition, it directly puts pressure on the heart by making it small and the heart’s compression generates difficulty in breathing. Fluid in the lungs can spread in other areas of the body also and when the heart stops functioning, it leads to hydrops i.e. heart failure.


Congenital High Airway Obstruction Syndrome is a very dangerous and scary disease. Its seriousness depends on factors like the blockage area, the severity of the damaged area, etc. If the blockage is in a small area then treatments can help to prevent it from further damage but if the whole area is affected then heart failure can occur for sure.


On the basis of the baby’s breathing, doctors suggest different ways of  treatment to the mother such as :

EXIT ( Ex Utero Intrapartum Treatment) –  Doctors and health providers ensure a safe delivery and a proper oxygen to the child. So cesarean is done and partial delivery happens when the baby’s head and neck are delivered via the uterus and the rest of the body stays attached with the placenta and oxygen is delivered through the umbilical cord. 

The remaining procedure could be done in two ways :

  1. Either by placing a camera near the baby’s mouth to see the condition of the airways by attaching an airway tube.
  2.  If the mouth is an inconvenient option, then doctors put an incision in the neck area and put the airway tube directly in the windpipe, below the windpipe to provide sufficient oxygen to the baby.

ECMO – Extracorporeal Membrane Oxygenation is a heart-lung bypass machine that works equally on the heart and lungs.

These two are the most reliable and most chosen treatments. But if none of these suits you, talk to your doctor as a doctor may be able to suggest additional options that can help lower the risk of CHAOS.


Based on observable symptoms, doctors undergo some tests to help the patient’s mother know more about Congenital High Airway Obstruction Syndrome.

For example, they may order :

An MRI (Magnetic Resonance Scan) to get an idea about the airway in the form of a picture and to measure the level of obstruction in the airway. 

Fetal Echocardiogram –  To monitor the heart’s functioning 

Amniocentesis – It can detect the chromosomal disorder and indicates other risks present in the screen test. 

Level 2 Ultrasound – Examines the overall airway.

After doing these tests, your doctor might recommend your genetic counselor to know in detail about gene-related family history and whether genes are doing all these or not.



A baby with CHAOS has so many medical problems, and may show these signs before birth or soon after the birth :

  • Downward force in breathing muscles
  • Instead of the left side, the heart slowly shifts towards the center.
  • Fluid increases in the body
  • Heart constriction
  • Chest swelling

Getting prompt and proper prenatal treatment can significantly reduce the chances of Congenital High Airway Obstructive Syndrome and improves the baby's overall health.


The actual reason is still hidden. But some predictions say CHAOS has something to do with genes and genetic problems just like Fraser's syndrome.



  1. See the doctor for frequent checkups and continuous fetal ultrasound can give internal updates such as change in symptoms.
  2. Amnioreduction should be done on most days of the week.
  3. Be in contact with a pediatric surgeon and ask queries if you have any.


The baby will be kept in a separate advanced room and their doctor will check the entire body’s activities especially heart and lungs, breathing process, total fluid content, baby’s nutrition,  everything is observed during this period.

Baby can go home but he/she has to pass some tests, then only the doctor can allow it.

Such as : 

  1. Normal breathing
  2. Increase in weight
  3. Proper food intake via mouth or tube
  4. The body’s temperature should stay norma


Though this condition is very rare, doctors are working on research and information and trying all the ways for the airway. But still survival rates depends on :

  1. Gestational age
  2. The severity of the symptoms 

But excellent prenatal and postnatal care, diagnosis, and on time treatment can help achieve good results and increase the baby’s survival rate and overall health.