Bilateral echogenic lungs (white arrow) with everted diaphragm (red arrow)  

Bilateral echogenic lungs (white arrow) with everted diaphragm (red arrow)  

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Congenital high airway obstruction syndrome (CHAOS) causes secondary morphological changes which can be detected on ultrasound. Here we report a case of congenital high airway obstruction with an occipital encephalocele detected at 23 weeks of gestation.

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Congenital malformations of the respiratory tract is an important issue. They cause more than 100 deaths annually in the Russian Federation. The definition and classification of congenital malformations of the respiratory tract are described and developed by Je. A. Cvetkov. The ultrasound is the primal method used in prenatal diagnosis of congenital malformations of the upper respiratory tract. Starting from the age of 17-23 weeks old, the ultrasound shows the following signs: hyperechoic lungs, dilatation of the lower respiratory tract, flattening of the diaphragm. This ultrasound pattern is typical for Congenital High Airway Obstruction Syndrome (CHAOS). If the doctor suspects an identifying of these signs, a follow-up examination is recommended. If the congenital obstruction of the upper respiratory tract is diagnosed during the pregnancy, the childbirth for patients must be performed in the hospital, where it is possible to perform tracheotomy and artificial ventilation of the lungs to the newborn, to operate him with placental support. This type of surgical treatment by the EXIT method (The ex utero intrapartum treatment procedure) is a new stage in neonatal surgery. A meta-analysis of 15 articles in the foreign literature about the detection of CHAOS from 1993 to 2014 was conducted. The analysis includes studies with more than 5 described cases. The statistics of diagnosis and treatment of congenital malformations of the larynx of patients of the ENT clinic of SPbSPMU for the period from 2003 to 2016 with the diagnosis of congenital malformation of the larynx is presented.