Reversion of the Ballantyne syndrome despite fetal hydrops persistence.
BACKGROUND
The Ballantyne syndrome (or mirror syndrome) is a gestational proteinuric hypertension associated with fetal hydrops. This report describes a case in which Ballantyne syndrome reversion occurred despite fetal hydrops persistence.


METHODS
A 24-year-old woman showed fetoplacental hydrops at 28 2/7 gestational weeks. Severe Rh(D) alloimmunization and fetal hemolytic anemia (fetal hematocrit 15.4%) were confirmed by cordocentesis, and an intrauterine transfusion was performed. She also revealed hypertension (160/100 mm Hg), edema and proteinuria (845 mg/day). After four intrauterine transfusions, blood pressure was normalized; urinary proteinuria was not significant, and the edema vanished completely. Fetal hydrops persisted until delivery at 32 gestational weeks, but a partial reduction of placental hydrops was noted.


CONCLUSIONS
Total or partial reduction of the placental edema may be responsible for the reversal of the Ballantyne syndrome despite the fetal hydrops persistence.
Lobato
Gustavo
G
Department of Obstetrics, Fernandes Figueira Institute, Oswaldo Cruz Foundation (IFF-FIOCRUZ), Rio de Janeiro, Brazil.
Nakamura-Pereira
Marcos
M
D001805:Blood Transfusion, Intrauterine; D004487:Edema / Q000503:physiopathology / Q000628:therapy; D004899:Erythroblastosis, Fetal / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006400:Hematocrit; D006801:Humans; D015160:Hydrops Fetalis / Q000503:physiopathology* / Q000628:therapy*; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000503:physiopathology* / Q000628:therapy*; D011247:Pregnancy; D012074:Remission Induction; D012203:Rh Isoimmunization; D055815:Young Adult