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Atrial fibrillation with rapid ventricular response as a maternal presentation of mirror syndrome: a case report

Elena HogenEsch1, Carly Dahl1, Alexander Samworth2

  • 1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Case Reports in Women'S Health
|November 25, 2022
PubMed

Mirror syndrome is the phenomenon of fetal hydrops causing maternal edema and weight gain. Here, we report a case of arrhythmia as the primary maternal symptom. A 36-year-old woman, G2P1001, at 34.5 weeks of gestation presented with new-onset fetal hydrops combined with maternal weight gain and edema. She developed atrial fibrillation with rapid ventricular response; cardiac workup was unremarkable. Rate control was achieved with diltiazem. She underwent delivery and reverted to normal sinus rhythm on post-operative day 1. Volume overload causes atrial wall stress and neurohormonal changes that may trigger atrial fibrillation. Optimization with rate control facilitated good maternal and fetal outcomes in this case.

Keywords:
AF, atrial fibrillationAtrial fibrillationCHF, congestive heart failureCMV, cytomegalovirusECG, electrocardiogramMaternal arrhythmiaNIFH, non-immune fetal hydropsNSR, normal sinus rhythmNonimmune fetal hydrops

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