Mirror syndrome associated with sacrococcygeal teratoma: a case report.
BACKGROUND
Mirror syndrome is associated with both nonimmune and immune hydrops fetalis. The clinical manifestations are quite varied, and the pathophysiology is poorly understood. We describe a case of mirror syndrome associated with afetus that had a rapidly growing sacrococcygeal teratoma (SCT) without overt hydrops.


METHODS
At 30 weeks' gestational age a fetus with SCT began to show early sonographic evidence of right heart failure, placentomegaly and polyhydramnios without overt fetal hydrops. Shortly after these findings were noted, the mother began to develop hypertension, epigastric pain, proteinuria and thrombocytopenia. These findings were all reversed after delivery of the fetus. Subsequent surgery on the infant was successful.


CONCLUSIONS
Mirror syndrome has been linked with SCT and is usually associated with severe fetal hydropic changes. In our case the development of mirror syndrome preceded the manifestations of overt hydrops. Identification of early signs of fetal compromise or hydrops may help to predict patients who will develop mirror syndrome and improve outcomes with earlier intervention.
Finamore
Peter S
PS
Division of Maternal Fetal Medicine, University of Medicine and Dentistry/Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. pfinamore@hotmail.com
Kontopoulos
Eftichia
E
Price
Mitchell
M
Giannina
Gregg
G
Smulian
John C
JC
D000293:Adolescent; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000601:surgery; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000175:diagnosis* / Q000517:prevention & control / Q000601:surgery; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000175:diagnosis* / Q000601:surgery