Document Detail


Long-term outcomes after fetal therapy for congenital high airway obstructive syndrome.
MedLine Citation:
PMID:  22703776     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Congenital high airway obstructive syndrome (CHAOS) is a rare and devastating condition that is uniformly fatal without fetal intervention. We sought to describe fetal treatment and long-term outcomes of CHAOS at a single referral center.
METHODS: The medical records of patients with fetal CHAOS evaluated at our center between 1993 and 2011 were reviewed. Maternal history, radiographic findings, antenatal management, and postnatal outcomes were compared.
RESULTS: Twelve fetuses with CHAOS were identified. Eleven had concomitant hydrops at diagnosis. Six were electively terminated, and 2 had intra- or peripartum demise. Four patients underwent fetal intervention. Two underwent delivery via ex utero intrapartum treatment (EXIT) procedure with tracheostomy placement only, and 2 underwent fetal bronchoscopy with attempted wire tracheoplasty followed by EXIT with tracheostomy at delivery. All 4 patients who underwent EXIT were alive at last follow-up. One patient was ventilator and tracheostomy free and feeding by mouth.
CONCLUSION: Long-term and tracheostomy-free survival is possible with appropriate fetal intervention even in the presence of hydrops. Fetal intervention earlier in pregnancy may improve long-term outcomes, but patient selection for intervention remains challenging. Magnetic resonance imaging may help select those patients for whom fetal intervention before EXIT delivery may be beneficial.
Authors:
Payam Saadai; Eric B Jelin; Amar Nijagal; Samuel C Schecter; Shinjiro Hirose; Tippi C Mackenzie; Larry Rand; Ruth Goldstein; Jody Farrell; Michael Harrison; Hanmin Lee
Related Documents :
15748696 - The differentiation profile of the epithelium of the human lip.
12540576 - Application of a saccharomyces cerevisiae model to study requirements for trafficking o...
1995846 - Characterization of intraepithelial lymphocytes in human endometrium.
16085046 - Maternal origin of inflammatory leukocytes in preterm fetal membranes, shown by fluores...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  47     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1095-100     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Alterations in maternal-fetal cellular trafficking after fetal surgery.
Next Document:  The effects of laparoscopic Nissen fundoplication on patients with severe gastroesophageal reflux di...