Mirror syndrome, also known as Ballantyne syndrome and Maternal Hydrops, is a condition that affects pregnant women. It is a rare disorder in which water retention in pregnant women mirrors fetal hydropic changes. That means there is an accumulation of fluid beneath the skin or in a cavity in both the mother, the fetus, and usually the placenta as well. It is sometimes referred to as triple edema, which indicates the fluid retention in all three places. Mirror syndrome is associated with preeclampsia, which means the fluid retention is linked to hypertension, or high blood pressure.
In addition to the high blood pressure and water retention, other indicators of mirror syndrome include protein in the urine, vomiting, and a general feeling of illness in the pregnant woman. This syndrome is dangerous for both mother and fetus and must be carefully monitored by a physician. The mother may experience bladder obstruction or a ruptured bladder, and the fetus may die. Extreme cases warrant an emergency cesarean.
Causes of mirror syndrome include general obstetric disorders, immunological disorders, infections, and malformations. Many times the cause of fetal hydrops is unknown and without knowing the cause, it is difficult to treat. Until the pathophysiology causing the fetal hydrops is definitely known, any treatment could be dangerous and harmful, so doctors must investigate all abnormalities that could trigger the disorder. Once fetal edema is discovered, usually during an ultrasound, doctors will test the mother for mirror syndrome to determine the best recourse.
Depending on the cause, and whether or not the cause is known, doctor’s will typically first order the mother to a strict bed rest regimen to reduce edema and hypertension. Each case of mirror syndrome is unique, so each instance will require a different treatment plan, if any treatment plan is given at all. Fetal surgery is extremely risky in these cases and not often advised. Delivery is always the best solution, but depending on the point of gestation, this is sometimes not an immediate option.
If doctors are, in fact, able to accurately determine the cause of fetal hydrops, treatment will depend on the cause. Treatments could include transfusions to correct anemia, medications for cardiac arrhythmia, reduction of lesions that impede cardiac venous or lymphatic return, or procedures to stop the loss of blood. Sometimes the mother may be given medications also, but the best course of action for mirror syndrome is always early detection so that the edema can be controlled before too much damage is incurred.