Ballantyne syndrome (the Mirror Syndrome) associated with severe non-immune fetal hydrops – a case report.

Abstract

Aim: to present a case study of the rapidly progressing non-immune fetal hydrops of the unknown etiology in the normal-karyotype fetus, accompanied by the severe maternal oedema, anaemia and hypoproteinemia. After the differential diagnosis, we establish the diagnosis of the Ballantyne syndrome (the Mirror Syndrome). Material and methods: We present a case of 31-year old multigravida in 22/24 week of pregnancy presenting the severe symptoms of non-immune fetal hydrops: subcutaneus oedema, hydrothorax, ascites and placental oedema associated with maternal oedema, anaemia and hypoproteinemia. After we excluded the cardiovascular, infectious, immune and morphological causes, we performed the amniocentesis and confirmed normal female 46, XX karyotype. Since the 22 week of pregnancy we observed the increasing maternal oedema and anaemia. We did not find any hematological, cardiac or nephrological causes of this condition. Results: In 24 week of pregnancy we diagnosed the intrauterine fetal demise, therefore the fetus was removed by the ceasarean section procedure. Shortly after the delivery, there was a resolution of maternal oedema, anaemia and hypoproteinemia. Conclusions: According to our results, we can conclude, that the mirror syndrome may develop in pregnancy complicated by NIHF of the unknown origin.