What do we know about the diagnosis and management of mirror syndrome?

Ayssa Teles Abrao Trad, Ricardo Czeresnia, Amro Elrefaei, Eniola R. Ibirogba, Kavita Narang, Rodrigo Ruano

Research output: Contribution to journalReview articlepeer-review


Introduction: Mirror syndrome is a rare disease associated with high fetal mortality of up to 67.2%. It is thought to be underdiagnosed and is often associated with preeclampsia. Mirror syndrome is characterized by “triple edema”: generalized maternal, placental, and fetal edema. Objective: This comprehensive review aims to thoroughly summarize the existing data and provide a broad update on the topic to help accurate diagnosis and encourage further research. Methods: A comprehensive search of several databases (Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus) was conducted. Results: The last systematic review of mirror syndrome cases was conducted in 2016 and included 113 patients. Much is still unknown about the pathophysiology of the disease and it remains underdiagnosed. Conclusions and relevance: Mirror syndrome is likely more prevalent than current data suggests for it is often misdiagnosed as pre-eclampsia. The differential of Mirror syndrome should be considered in anomalous presentations of pre-eclampsia as intervention may save the fetus and improve maternal symptoms. It is important to further the study on the pathophysiology of the disease to better understand, diagnose and potentially treat it, to avoid its high morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)4022-4027
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number20
StatePublished - 2022


  • Ballantyne’s syndrome
  • Mirror syndrome
  • fetal
  • hydrops
  • maternal
  • preeclampsia
  • prenatal diagnosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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