Department of Neonatology, Chongqing Health Center for Women and Children, Longshan Road 120, Chongqing, China.
Department of Pediatrics, University Hospital Magdeburg, Magdeburg, Germany.
BMC Pregnancy Childbirth. 2021 Oct 18;21(1):701. doi: 10.1186/s12884-021-04179-5.
Mirror syndrome (MS) is defined as maternal edema with fetal hydrops and placental edema with different etiologies, such as rhesus isoimmunization and twin-twin transfusion syndrome. Herein, we showcased a unique MS case secondary to fetomaternal hemorrhage (FMH).
A 32-year-old gravida 2 para 0 woman diagnosed with fetal hydrops was admitted to our hospital. Maternal laboratory tests revealed anemia, slightly increased creatinine and uric acid levels, hypoproteinemia, and significantly increased alpha-fetoprotein and hemoglobin-F levels. Therefore, FMH was diagnosed initially. Two days after admission, the woman had unexpectedly progressive anasarca and started to feel chest distress, palpitations, lethargy, and oliguria, and MS was suspected. An emergency cesarean section was performed to terminate the pregnancy. The maternal clinical symptoms and laboratory tests rapidly improved after delivery. A very preterm infant with a 2080-g birthweight at 31 weeks gestation survived after emergency cesarean section, active resuscitation, emergency blood transfusion, abdominocentesis, and advanced life support.
FMH could develop into MS, providing new insights into the etiology of MS. Once MS is diagnosed, emergency cesarean section might be an alternative treatment. The very preterm infant survived with a favorable long-term outcome, and a well-trained perinatal work team is needed for such cases.
镜像综合征 (MS) 定义为母体水肿伴胎儿水肿和胎盘水肿，其病因不同，如 Rh 同种免疫和双胎输血综合征。在此，我们展示了一例由胎儿-母体出血 (FMH) 引起的独特 MS 病例。
一名 32 岁初产妇，因胎儿水肿被收入我院。母体实验室检查显示贫血、肌酐和尿酸水平略有升高、低蛋白血症，以及明显升高的甲胎蛋白和血红蛋白 F 水平。因此，最初诊断为 FMH。入院 2 天后，该妇女意外出现进行性全身水肿，并开始感到胸闷、心悸、乏力和少尿，怀疑 MS。紧急剖宫产终止妊娠。分娩后，产妇临床症状和实验室检查迅速改善。一个极早产儿，胎龄 31 周，出生体重 2080 克，经紧急剖宫产、积极复苏、紧急输血、腹腔穿刺和高级生命支持后存活。
FMH 可发展为 MS，为 MS 的病因提供了新的见解。一旦诊断为 MS，紧急剖宫产可能是一种替代治疗方法。极早产儿存活，预后良好，此类病例需要有经验丰富的围产工作团队。
