Giacobbe Annamaria, Grasso Roberta, Interdonato Maria Lieta, Laganà Antonio Simone, Valentina Giacobbe, Triolo Onofrio, Mancuso Alfredo
Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University Hospital, Messina, Italy.
J Matern Fetal Neonatal Med. 2013 Feb;26(3):313-5. doi: 10.3109/14767058.2012.722734. Epub 2012 Sep 25.
Mirror syndrome is a triad consisting of fetal hydrops, maternal edema and placentomegaly. Its pathogenesis is unclear and it is frequently mistaken for preeclampsia, even though distinguishing features can be identified. It is associated with an increase in fetal mortality and maternal morbility.
We report an uncommon case of mirror syndrome, which appeared late in pregnancy (38 weeks) in a young nulliparous and characterized by sudden and massive vulvar edema, with placentomegaly and hydramnios but without fetal hydrops.
Our report is an interesting example of an unusual form of Mirror syndrome for several reasons. First of all, the gestational age in which the disorder appeared differs remarkably from the data of literature; in our case, clinical signs and symptoms appeared only at 37 weeks. Another difference consists in the lack of hypertension that represents the second most common symptom associated and explains the difficulty to differentiate this syndrome from preeclampsia.
Although mirror syndrome is associated with an increase in perinatal mortality, in the case we reported the late onset of the disorder associated with the medical treatment and the timely decision to perform a caesarean section allowed the birth of a healthy baby.
镜像综合征是一种由胎儿水肿、母体水肿和胎盘肿大组成的三联征。其发病机制尚不清楚,尽管可以识别出其特征性表现,但仍常被误诊为子痫前期。它与胎儿死亡率和母体发病率的增加有关。
我们报告了一例罕见的镜像综合征病例,该病例发生在一名年轻初产妇妊娠晚期(38周),其特征为突然出现大量外阴水肿,伴有胎盘肿大和羊水过多,但无胎儿水肿。
我们的报告是镜像综合征一种不寻常形式的有趣例子,原因有几个。首先,该疾病出现的孕周与文献数据有显著差异;在我们的病例中,临床体征和症状直到37周才出现。另一个不同之处在于缺乏高血压,高血压是与之相关的第二常见症状,这也解释了将该综合征与子痫前期区分开来的困难。
尽管镜像综合征与围产期死亡率增加有关,但在我们报告的病例中,该疾病的晚发、医疗干预以及及时决定进行剖宫产使得一名健康婴儿得以出生。