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母亲和胎儿均患镜像综合征合并非致密性心肌病。病例报告。

Mirror syndrome with noncompaction cardiomyopathy in the mother and fetus. Case report.

机构信息

Hospital Universitario San Vicente Fundación, Medellín (Colombia)..

Facultad de Medicina, Universidad de Antioquia, Medellín (Colombia). .

出版信息

Rev Colomb Obstet Ginecol. 2021 Sep 30;72(3):298-306. doi: 10.18597/rcog.3659.

Abstract

OBJECTIVE

To report the case of a pregnant woman with mirror syndrome associated with non-compaction cardiomyopathy in the mother and the fetus, in which antenatal medical treatment provided to the mother resulted in a favorable perinatal maternal outcome.

CASE PRESENTATION

A 16-year old primigravida with 33 weeks of gestation referred from a Level I institution to a private Level IV center in Medellín, Colombia, because of a finding of fetal hydrops on obstetric ultrasound. During hospitalization, the patient showed clinical and ultrasonographic signs of heart failure (dyspnea, edema and hypoxemia), with the diagnosis of hydrops fetalis (mirror syndrome) also confirmed. Diuretic treatment with furosemide was initiated in the mother, with subsequent improvement of the maternal condition as well as of the fetal edema. During the subacute postpartum period in the hospital, the presence of non-compaction cardiomyopathy was confirmed on cardiac nuclear magnetic resonance imaging in both the mother and the newborn. After discharge in adequated condition, they were included in the cardiovascular follow-up program for heart failure and congenital heart disease, respectively.

CONCLUSION

A case of mirror syndrome associated with maternal and fetal non-compaction cardiomyopathy is presented. There is a limited number of reports on mirror syndrome due to cardiac anomalies (maternal and fetal), with weak treatment descriptions, pointing to the need for research in this area. It would be important to consider the diagnosis of non-compaction cardiomyopathy in fetuses with hydrops unrelated to isoimmunization or cardiac dysfunction, and approach these cases from a multi-disciplinary perspective.

摘要

目的

报告一例与母体和胎儿非致密性心肌病相关的镜像综合征孕妇病例,其中对母体的产前治疗导致围产期母婴结局良好。

病例介绍

一名 16 岁初产妇,妊娠 33 周,因产科超声发现胎儿水肿从一级机构转诊至哥伦比亚麦德林的一家四级私人中心。住院期间,患者出现心力衰竭的临床和超声征象(呼吸困难、水肿和低氧血症),胎儿水肿(镜像综合征)的诊断也得到了证实。母亲开始用呋塞米进行利尿剂治疗,随后母亲的病情以及胎儿水肿均得到改善。在医院亚急性产后期间,母亲和新生儿的心脏磁共振成像均证实存在非致密性心肌病。出院时情况良好,他们分别被纳入心力衰竭和先天性心脏病的心血管随访计划。

结论

报告一例与母体和胎儿非致密性心肌病相关的镜像综合征病例。由于心脏异常(母体和胎儿)导致的镜像综合征报告数量有限,且治疗描述较弱,这表明需要在该领域进行研究。在与免疫性或心功能障碍无关的胎儿水肿病例中,考虑非致密性心肌病的诊断,并从多学科角度处理这些病例非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a7f/8614231/4e3c48e7c2a3/2463-0225-rcog-72-03-3659-gf1.jpg

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