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- W4246996891 abstract "We present a 28-year-old primigravida with fetal congenital high airway obstruction syndrome (CHAOS) syndrome who had ex utero intrapartum treatment (EXIT) procedure at 34 weeks of gestation. EXIT procedure is a modification of a caesarean section which maintains fetal oxygenation using the placental circulation to gain crucial time to allow the fetal airway to be secured by endotracheal intubation or tracheostomy. This procedure carries higher rate of complications for both the mother (hemorrhage, general anesthesia) and the fetus (death if airway is not secured). Appropriate surgical planning and a multi-disciplinary approach is of utmost importance. A fetal MRI was performed at 32 weeks as an adjunct to ultrasound. A volumetric reconstruction was executed based on rigid motion correction of the acquired 2D MRI slices combined with robust outlier detection to obtain an isotropic high-resolution visualisation of the trachea. The reconstructed volume was generated with a larger region of interest to aid spatial orientation and was reviewed by a pediatric radiologist alongside native images. MRI confirmed the diagnosis of CHAOS, established a laryngeal level of obstruction, and highlighted the possibility of a small trace of fluid traversing the obstruction. During the EXIT a laryngoscopy confirmed a small pin hole traversing the obstruction and therefore the team proceeded to successfully perform a tracheostomy. Improved resolution allowed accurate anatomical delineation of the level and characteristics of the obstruction. This has the potential to ensure that the appropriate clinical teams and equipment are available at time of EXIT in order to achieve a secure airway whilst avoiding EXIT in cases where this is not needed." @default.
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- W4246996891 date "2020-10-01" @default.
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- W4246996891 title "VP20.10: Use of super resolution reconstruction MRI for surgical planning in a fetus with congenital high airway obstruction syndrome: a case report" @default.
- W4246996891 doi "https://doi.org/10.1002/uog.22647" @default.
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