Resolution of maternal Mirror syndrome after succesful fetal intrauterine therapy: a case series

Angel Chimenea,María Moreno-De Las Heras,Ana María Calderón,Guillermo Antiñolo,Lutgardo García-Díaz

doi:10.1186/s12884-018-1718-0

Abstract

BackgroundMirror syndrome (MS) is a rare obstetric condition usually defined as the development of maternal edema in association with fetal hydrops. The pathogenesis of MS remains unclear and may be misdiagnosed as pre-eclampsia.Case presentationWe report a case series of MS in which fetal therapy (intrauterine blood transfusion and pleuroamniotic shunt) resulted in fetal as well as maternal favourable course with complete resolution of the condition in both mother and fetus.ConclusionsOur case series add new evidence to support that early diagnosis of MS followed by fetal therapy and clinical maternal support are critical for a good outcome.

Highlights

Mirror syndrome (MS) is a rare obstetric condition usually defined as the development of maternal edema in association with fetal hydrops
Mirror syndrome (MS) is a rare complication of fetal hydrops appearing as a triple edema [1], in which the mother “mirrors” the hydropic fetus
There have been multiple feto-placental diseases related to MS, that can be classified into diverse groups based on different etiologies [3]: cardiac failure associated with fetal anemia (e.g. Parvovirus B19 [4], erytroblastosis [5], fetal alloimmune thrombocytopenia [6], hemoglobin Bart’s disease [7]); high-output cardiac failure associated with shunting; and fetal anomalies

Summary

Introduction

Mirror syndrome (MS) is a rare obstetric condition usually defined as the development of maternal edema in association with fetal hydrops. If correction of the fetal condition is not possible, delivery usually results in a favourable maternal outcome [17]. Vaginal delivery may be preferred, but complications as maternal pulmonary edema or deterioration of the fetal condition can lead to an emergent caesarean section [18,19,20].

Results

Conclusion