TY - JOUR
T1 - Mirror syndrome in monochorionic diamniotic twins presenting as maternal hyponatremia
T2 - A case report
AU - Hussain, Farrah Naz
AU - Parikh, Bijal
AU - Shenoy, Mangalore S.
AU - Al-Ibraheemi, Zainab
AU - Lewis, Dawnette
N1 - Funding Information:
All authors made substantial contributions to patient care, the conception and design of the case report, and drafting the article or revising it critically for important intellectual content. All gave final approval of the version submitted. No funding was received for this work. Written informed consent from the patient was obtained prior to preparation of this case report. This article was not commissioned and was peer reviewed.
Publisher Copyright:
© 2022 The Authors
PY - 2022/4
Y1 - 2022/4
N2 - This is a case report of a 39-year-old patient, G5P1031, with monochorionic diamniotic twins at 30 weeks and 1 day of gestation, who developed mirror syndrome without twin-to-twin transfusion syndrome (TTTS) with a unique presentation of maternal and neonatal hyponatremia. Coinciding with severe hyponatremia were maternal symptoms of edema, nausea and vomiting, hypoalbuminemia, elevated uric acid, as well as fetal selective growth restriction, polyhydramnios, umbilical artery absent end diastolic flow and prolonged bradycardia of twin B. Given the poor status of twin B and the risks to twin A, the patient underwent emergent cesarean delivery. Hyponatremia in all three patients resolved in the following 48–72 h. Mirror syndrome is associated with significant maternal and fetal morbidity and mortality. In this case, severe hyponatremia posed additional risks. Therefore, electrolyte monitoring should be considered in both mother and neonate(s).
AB - This is a case report of a 39-year-old patient, G5P1031, with monochorionic diamniotic twins at 30 weeks and 1 day of gestation, who developed mirror syndrome without twin-to-twin transfusion syndrome (TTTS) with a unique presentation of maternal and neonatal hyponatremia. Coinciding with severe hyponatremia were maternal symptoms of edema, nausea and vomiting, hypoalbuminemia, elevated uric acid, as well as fetal selective growth restriction, polyhydramnios, umbilical artery absent end diastolic flow and prolonged bradycardia of twin B. Given the poor status of twin B and the risks to twin A, the patient underwent emergent cesarean delivery. Hyponatremia in all three patients resolved in the following 48–72 h. Mirror syndrome is associated with significant maternal and fetal morbidity and mortality. In this case, severe hyponatremia posed additional risks. Therefore, electrolyte monitoring should be considered in both mother and neonate(s).
KW - Hyponatremia
KW - Mirror syndrome
KW - Monochorionic diamniotic twins
KW - Triple edema
UR - http://www.scopus.com/inward/record.url?scp=85124835115&partnerID=8YFLogxK
U2 - 10.1016/j.crwh.2022.e00401
DO - 10.1016/j.crwh.2022.e00401
M3 - Article
AN - SCOPUS:85124835115
SN - 2214-9112
VL - 34
JO - Case Reports in Women's Health
JF - Case Reports in Women's Health
M1 - e00401
ER -