title: Maternal mirror syndrome after in utero aortic valve dilation. A case report.
abstract: Fetal hydrops of various etiologies can be associated with maternal mirror syndrome. The exact pathophysiology of this rare disorder remains unclear, yet it can result in significant maternal and fetal morbidity. The recent advances in prenatal diagnosis and therapeutic interventions have focused on altering the course of pathologies associated with an expected poor prognosis. Severe fetal aortic valve stenosis with its potential for hypoplastic left heart fit this category. We report a case of maternal mirror syndrome in a parturient following intrauterine therapy for severe fetal aortic stenosis and hydrops. Despite a technically successful intervention, the mother required emergency cesarean section. We review the few reports of mirror syndrome as well as the current approaches to fetal aortic stenosis. This case reinforces the need for in depth risk analysis prior to fetal interventions. It also emphasizes the advantage of earlier detection and therapy with fetal aortic stenosis since fetal hydrops carries a somber prognosis.
authors.affiliation: Department of Anesthesiology, Pain and Perioperative Medicine, Children's Hospital and Harvard Medical School, Boston, Mass. 02115, USA. arielle.mizrahi@childrens.harvard.edu
authors.forename: Arielle
authors.initials: A
authors.lastname: Mizrahi-Arnaud
authors.forename: Louise
authors.initials: L
authors.lastname: Wilkins Haug
authors.forename: Audrey
authors.initials: A
authors.lastname: Marshall
authors.forename: Virginia
authors.initials: V
authors.lastname: Silva
mesh_terms: D000328:Adult; D001024:Aortic Valve Stenosis / Q000628:therapy*; D002404:Catheterization; D017809:Fatal Outcome; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D006801:Humans; D015160:Hydrops Fetalis / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011654:Pulmonary Edema / Q000209:etiology; D013577:Syndrome; D013610:Tachycardia / Q000209:etiology