Mirror Syndrome of Pregnancy

It is the unusual association of fetal and placental hydrops  with maternal pre-eclampsia. "Mirror syndrome" refers to the similarity between maternal oedema and fetal hydrops. Cause may be any of the variety of  obstetric problems  which  range from Rh iso-immunisation disorders,  to fetal infections, metabolic disorders, and fetal malformations. Ballantyne syndrome can result from the maternal reaction to a fetus that has hemoglobin Bart's disease due to inherited double thalassemia trait from both parents. This syndrome may present in a mother with missed Trisomy 21 screening and where in pregnancy continues and baby develops hydrops and mother may present with features of PET

Signs and Symptoms

 Edema always present, mild proteinuria and PET

Differential diagnosis

The etiology of severe fetal hydrops may cause Mirror  syndrome when the fetal status greatly worsens and that the syndrome is only a manifestation of the extreme severity of the fetus-placental pathology. Platelet count, ALT, AST are usually normal and may be used to distinguish from HELLP syndrome