Mirror syndrome: a literature review

Abstract

Mirror syndrome, or Ballantyne syndrome (BS), was described for the first time in 1892 by John W. Ballantyne. It is classically defined as triple oedema: association of foetal, placental and maternal oedema. In this syndrome, a pregnant woman with hydrops fetalis reflects (as in a mirror) the signs present in the foetus and develops symptoms similar to those displayed by the foetus. Mirror syndrome is not a widely described disease, its prevalence is unknown and there are relatively few literature reports of the condition. It coexists with various pathologies of pregnancy and structural anomalies of the foetus and placenta; it may occur after viral infections during pregnancy. The pathogenesis of Ballantyne syndrome remains unexplained and there is a wide variety of clinical signs. There exist theories for the pathomechanism of the syndrome, but none of them is fully satisfactory. Mirror syndrome is potentially life-threatening and is associated with increased foetal mortality and maternal morbidity. The treatment of choice for mirror syndrome in the mother is the treatment of oedema in the foetus, as the aetiology of the condition suggests. In mirror syndrome, the prognosis for the foetus is unfavourable and many cases end with intrauterine death. The treatment of hydrops fetalis, regardless of its cause, often leads to the resolution of symptoms in the mother, and, at the same time, better prognosis for the foetus.

A singleton pregnancy with placental chorioangioma and hydrops fetalis complicated with mirror syndrome and ritodrine-induced side effects: A case report

“…Nevertheless, this disorder is often misdiagnosed because of preeclampsia-like manifestations. Differentiating between MS and preeclampsia-like syndromes may be di cult, and the only difference lies in fetal edema, which is present in MS [14,15]. Our case demonstrated a larger chorioangioma, which was 8.5 cm in diameter, and the patient presented with severe pulmonary edema, progressive lower leg edema and hydrops fetalis.…”

Is Fetal Hydrops in Turner Syndrome a Risk Factor for the Development of Maternal Mirror Syndrome?

“…Our results are in stark contrast to prior reports of the rates of Mirror syndrome ranging from 5% to 37.8% among fetal hydrops associated with other conditions [ 12 , 14 , 15 ]. These conditions include rhesus alloimmunization, viral infections, Ebstein’s anomaly, aneurysm of the vein of Galen, sacrococcygeal teratoma (SCT), supraventricular tachycardia (SVT), twin to twin transfusion syndrome (TTTS), hemoglobin Bart’s and placental chorioangioma [ 3 , 7 , 34 , 35 , 36 ].…”

Faktor Risiko dan Manajemen Mirror Syndrome

“…Hal ini ditandai dengan cepat pertumbuhan dan pembuluh darah yang kaya, yang mengarah ke tandatanda dari kegagalan sirkulasi. Pada pasien dengan MS terkait dengan teratoma sacrococcygeal janin sebagai berikut dengan manifestasi yang terjadi yaitu : nyeri sakral, edema tungkai,proteinuria, hipertensi arteri, dan hidronefrosis derajat 1 (Hermyt et al, 2019).…”