How do we treat congenital high airway obstruction syndrome?
CHAOS treatment depends on several factors. If the baby does not have evidence of hydrops, we will offer an EXIT procedure around 36 to 38 weeks gestation. An EXIT procedure is a complex operation that helps deliver babies who may not be able to breathe after delivery. In an EXIT procedure, we deliver your baby while it is still on placental circulation, which means that the baby is still receiving necessary oxygen from the mother through the umbilical cord.
If we identify fetal hydrops, treatment depends on your baby’s gestational age:
- Before 30 weeks, for a baby with CHAOS and fetal hydrops, we will offer fetoscopy to open the obstruction. We first place a camera into the uterus. We then move it through the baby’s mouth, into the back of the throat and into the upper airway and create an opening through the obstruction to relieve the pressure that has built up.
- After 30 weeks, for a baby with CHAOS and fetal hydrops, we will offer an EXIT procedure. Once we deliver the baby, we create a hole through the obstruction and place a breathing tube into that hole. If that is not feasible, we will perform a tracheostomy, which surgically places a breathing tube through the neck and into the trachea to help your baby breathe.
Why choose us for treatment of congenital high airway obstruction syndrome?
CHAOS is a rare condition, so it’s hard to find fetal care teams who are experienced in caring for it. We have an expert team composed of maternal fetal medicine doctors, pediatric surgeons, otolaryngologists, fetal anesthesiologists and neonatologists who are well-versed in caring for babies with CHAOS.
Children’s Hospital Colorado has an outstanding group of fetal care specialists at our Colorado Fetal Care Center who have a wealth of experience with both fetoscopy and EXIT procedures. EXIT procedures are complex and require a large and specialized team operating with state-of-the-art equipment and rooms. You’ll find all that at our Center.
All our specialists have additional training and education in working with families who have prenatal diagnoses. You’ll receive care from imaging specialists, nurses, therapists and doctors who work only with families like yours. After your baby is born, they’ll recover and grow in our Level IV (four) Neonatal Intensive Care Unit (NICU), which holds the highest possible designation for NICUs and is staffed by one of the most experienced teams in the country.