Rev Bras Ginecol Obstet 2016; 38(11): 576-579
DOI: 10.1055/s-0036-1593895
Case Report
Thieme Publicações Ltda Rio de Janeiro, Brazil

Mirror Syndrome after Fetoscopic Laser Treatment - A Case Report

Síndrome do espelho após tratamento laser por fetoscopia - caso clínico
Ana Maria Simões Brandão
1   Obstetrics Unit A, Maternidade Dr. Daniel de Matos, Centro Hospitalar e Universitário de Coimbra (CHUC), Faculdade de Medicina, Universidade de Coimbra, Portugal
,
Ana Patrícia Rodrigues Domingues
1   Obstetrics Unit A, Maternidade Dr. Daniel de Matos, Centro Hospitalar e Universitário de Coimbra (CHUC), Faculdade de Medicina, Universidade de Coimbra, Portugal
,
Etelvina Morais Ferreira Fonseca
1   Obstetrics Unit A, Maternidade Dr. Daniel de Matos, Centro Hospitalar e Universitário de Coimbra (CHUC), Faculdade de Medicina, Universidade de Coimbra, Portugal
,
Teresa Maria Antunes Miranda
1   Obstetrics Unit A, Maternidade Dr. Daniel de Matos, Centro Hospitalar e Universitário de Coimbra (CHUC), Faculdade de Medicina, Universidade de Coimbra, Portugal
,
José Paulo Achando Silva Moura
1   Obstetrics Unit A, Maternidade Dr. Daniel de Matos, Centro Hospitalar e Universitário de Coimbra (CHUC), Faculdade de Medicina, Universidade de Coimbra, Portugal
› Author Affiliations
Further Information

Publication History

19 May 2016

27 September 2016

Publication Date:
22 December 2016 (online)

Abstract

Mirror syndrome is a rare disease with unknown pathophysiology that can be present in different diseases that can cause fetal hydrops. The prognosis is usually bad with a high perinatal mortality. We report an unusual form of mirror syndrome that manifested itself only after a successful treatment for fetal hydrops (caused by twin-twin transfusion syndrome, in Quinteros stage IV) was performed. This syndrome was controlled by medical treatment, and despite the usually bad prognosis seen in these cases, we could extend the pregnancy from the 23rd to the 34th week of gestation, resulting in the birth of 2 live infants.

Resumo

A síndrome do espelho é uma doença rara, de fisiopatologia desconhecida, que se manifesta em situações obstétricas responsáveis pela presença de hidrópsia fetal. Habitualmente o prognóstico é reservado, uma vez que se associa a elevadas taxas de mortalidade perinatal. O presente caso clínico trata de uma situação de síndrome do espelho que se manifestou, atipicamente, após o tratamento eficaz para a hidrópsia fetal associada à síndrome de transfusão feto-fetal.

Apesar do mau prognóstico associado a estas situações, conseguiu-se controlar a situação apenas com tratamento médico e, desta forma, prolongar a gravidez durante 12 semanas.

 
  • References

  • 1 Braun T, Brauer M, Fuchs I , et al. Mirror syndrome: a systematic review of fetal associated conditions, maternal presentation and perinatal outcome. Fetal Diagn Ther 2010; 27 (4) 191-203
  • 2 Giacobbe A, Grasso R, Interdonato ML , et al. An unusual form of mirror syndrome: a case report. J Matern Fetal Neonatal Med 2013; 26 (3) 313-315
  • 3 Gedikbasi A, Oztarhan K, Gunenc Z , et al. Preeclampsia due to fetal non-immune hydrops: mirror syndrome and review of literature. Hypertens Pregnancy 2011; 30 (3) 322-330
  • 4 Graham N, Garrod A, Bullen P, Heazell AE. Placental expression of anti-angiogenic proteins in mirror syndrome: a case report. Placenta 2012; 33 (6) 528-531
  • 5 Kumar B, Nazaretian SP, Ryan AJ, Simpson I. Mirror syndrome: a rare entity. Pathology 2007; 39 (3) 373-375
  • 6 Vidaeff AC, Pschirrer ER, Mastrobattista JM, Gilstrap III LC, Ramin SM. Mirror syndrome. A case report. J Reprod Med 2002; 47 (9) 770-774
  • 7 Bixel K, Silasi M, Zelop CM , et al. Placental origins of angiogenic dysfunction in mirror syndrome. Hypertens Pregnancy 2012; 31 (2) 211-217
  • 8 Prefumo F, Pagani G, Fratelli N, Benigni A, Frusca T. Increased concentrations of antiangiogenic factors in mirror syndrome complicating twin-to-twin transfusion syndrome. Prenat Diagn 2010; 30 (4) 378-379
  • 9 Llurba E, Marsal G, Sanchez O , et al. Angiogenic and antiangiogenic factors before and after resolution of maternal mirror syndrome. Ultrasound Obstet Gynecol 2012; 40 (3) 367-369
  • 10 Chang YL, Chao AS, Hsu JJ, Chang SD, Soong YK. Selective fetocide reversed mirror syndrome in a dichorionic triplet pregnancy with severe twin-twin transfusion syndrome: a case report. Fetal Diagn Ther 2007; 22 (6) 428-430
  • 11 Hayashi S, Sago H, Hayashi R , et al. Manifestation of mirror syndrome after fetoscopic laser photocoagulation in severe twin-twin transfusion syndrome. Fetal Diagn Ther 2006; 21 (1) 51-54
  • 12 Herberg U, Gross W, Bartmann P, Banek CS, Hecher K, Breuer J. Long term cardiac follow up of severe twin to twin transfusion syndrome after intrauterine laser coagulation. Heart 2006; 92 (1) 95-100
  • 13 Habli M, Michelfelder E, Cnota J , et al. Prevalence and progression of recipient-twin cardiomyopathy in early-stage twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2012; 39 (1) 63-68
  • 14 Chang YL, Chao AS, Chang SD, Wang CN. Mirror syndrome after fetoscopic laser therapy for twin-twin transfusion syndrome due to transient donor hydrops that resolved before delivery. A case report. J Reprod Med 2014; 59 (1-2) 90-92