Ballantyne syndrome: is placental ischemia the etiology?
Ballantyne syndrome is a condition in which the gravid patient essentially "mirrors" the in utero state of the hydropic fetus. The exact pathophysiological mechanism, however, is unclear. At 25 weeks gestation, a 28-year-old G3P2 presented with acute onset lower extremity edema, hyperuricemia, polyhydramnios, generalized pruritus, hemodilutional anemia, and pre-term labor. The human chorionic gonadotrophin (hCG) level was markedly elevated, at 570,020 mIU/ml. Postpartum, she developed a pre-eclampsia-like syndrome with oliguria and pulmonary effusions. Associated placental findings included a 8 x 7 x 7 cm chorangioma. Underlying placental ischemia, reflected by a hyperproliferative trophoblast, increased hCG secretion, and increased placental resistance may account for the maternal findings of Ballantyne syndrome.
Gherman
R B
RB
Department of Obstetrics and Gynecology, Portsmouth Naval Hospital, Virginia 23708-2197, USA. ghermtoo@aol.com
Incerpi
M H
MH
Wing
D A
DA
Goodwin
T M
TM
D000328:Adult; D000740:Anemia / Q000209:etiology; D004231:Diuresis; D004487:Edema / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007231:Infant, Newborn; D007511:Ischemia / Q000150:complications*; D008297:Male; D007752:Obstetric Labor, Premature / Q000209:etiology; D010920:Placenta / Q000098:blood supply*; D006831:Polyhydramnios / Q000209:etiology; D011247:Pregnancy; D011537:Pruritus / Q000209:etiology; D013577:Syndrome; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid