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Characteristics and management of mirror syndrome: a systematic review (1956–2016)

  • Sabah Allarakia , Hassan A. Khayat EMAIL logo , Moyassar M. Karami , Abdulaziz M. Aldakhil , Ahmed M. Kashi , Abdulrahman H. Algain , Mohammad A. Khan , Loai S. Alghifees and Raed E. Alsulami
Published/Copyright: March 20, 2017
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 45 Issue 9

Abstract

Objectives:

To describe the clinical features of mirror syndrome and to correlate the effects of different treatments with the fetal outcomes.

Data sources:

Online search up to May 2016 was conducted in the PubMed, Embase (Ovid platform) and clinicalTrials.gov without restrictions of language, date or journal. Only papers providing both fetal and maternal presentations and outcomes were included.

Results:

The study included 74 papers (n=111), with an additional two patients diagnosed at our center (n=113). The mean gestational age at diagnosis was 27 weeks±30 days (16–39 weeks). Whether early or late gestational age at diagnosis, and whether mother and fetus show symptoms simultaneously or on different dates, has insignificant impact on fetal outcome (P=0.06 and P=0.46, respectively). Edema (84%) followed by hypertension (60.1%) were the leading maternal findings. Fetal hydrops (94.7%) and placental edema (62.8%) were the commonest sonographic features. Procedures correcting fetal hydrops/anemia in utero as well as labor induction were the only treatment options correlated with improved fetal survival (χ2 analysis, P=0.01 and Fisher’s exact test, P=0.02; respectively). The overall rate of fetal/neonatal mortality was 67.26%.

Conclusion:

The gestational age at diagnosis and sequence of presentation have insignificant impact on fetal outcome. Improved fetal survival was associated with procedural interventions that correct fetal hydrops as well as labor induction.

Keywords: Acute second trimester gestosis; ballantyne syndrome; fetal hydrops; fetal survival; maternal edema; maternal hydrops syndrome; maternal recovery; mirror syndrome; placental hydrops; pseudotoxemia; triple edema

  1. Disclosure: The authors of this study disclose “no” source of potential support or sponsor names or any financial involvement that represent potential conflict of interest.

    This paper was not part of a presentation/poster at a meeting and has not been considered for publication by any journal.

  2. Author’s statement

  3. Conflict of interest: Authors state no conflict of interest.

  4. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  5. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

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Supplemental Material:

The online version of this article offers supplementary material (DOI: https://doi.org/10.1515/jpm-2016-0422).

Received: 2016-12-27
Accepted: 2017-1-17
Published Online: 2017-3-20
Published in Print: 2017-12-20

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Corner of Academy
  3. Perinatal critical care and ethics in perinatal medicine: the role of the perinatologist
  4. Review articles
  5. The impact of psychological distress during pregnancy on the developing fetus: biological mechanisms and the potential benefits of mindfulness interventions
  6. Characteristics and management of mirror syndrome: a systematic review (1956–2016)
  7. Congenital pulmonary lymphangiectasia
  8. Original articles
  9. A definition of gentle ventilation in congenital diaphragmatic hernia: a survey of neonatologists and pediatric surgeons
  10. Three-dimensional ultrasound first trimester fetal volume measurement and its relation to pregnancy outcome
  11. Evidence of altered brain regulatory gene expression in tobacco-exposed fetuses
  12. Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
  13. The impact of maternal obesity on completion of fetal anomaly screening
  14. The effect of fish oil supplementation on maternal and neonatal outcomes: a triple-blind, randomized controlled trial
  15. Letter to the Editor
  16. Respect for professors: an often underappreciated component of professionalism in medical education
  17. Congress Calendar
  18. Congress Calendar
https://doi.org/10.1515/jpm-2016-0422
Keywords for this article
Acute second trimester gestosis; ballantyne syndrome; fetal hydrops; fetal survival; maternal edema; maternal hydrops syndrome; maternal recovery; mirror syndrome; placental hydrops; pseudotoxemia; triple edema

Articles in the same Issue

  1. Frontmatter
  2. Corner of Academy
  3. Perinatal critical care and ethics in perinatal medicine: the role of the perinatologist
  4. Review articles
  5. The impact of psychological distress during pregnancy on the developing fetus: biological mechanisms and the potential benefits of mindfulness interventions
  6. Characteristics and management of mirror syndrome: a systematic review (1956–2016)
  7. Congenital pulmonary lymphangiectasia
  8. Original articles
  9. A definition of gentle ventilation in congenital diaphragmatic hernia: a survey of neonatologists and pediatric surgeons
  10. Three-dimensional ultrasound first trimester fetal volume measurement and its relation to pregnancy outcome
  11. Evidence of altered brain regulatory gene expression in tobacco-exposed fetuses
  12. Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
  13. The impact of maternal obesity on completion of fetal anomaly screening
  14. The effect of fish oil supplementation on maternal and neonatal outcomes: a triple-blind, randomized controlled trial
  15. Letter to the Editor
  16. Respect for professors: an often underappreciated component of professionalism in medical education
  17. Congress Calendar
  18. Congress Calendar
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