Mirror syndrome: a systematic literature review

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Mirror syndrome, a rare condition, involves maternal edema, fetal hydrops, and placental edema.
• Its diagnostic criteria and clinical presentation require comprehensive review and synthesis.

Purpose of the Study:

• To systematically review and synthesize the diagnostic criteria for mirror syndrome.
• To describe the clinical presentation and outcomes associated with mirror syndrome.

Main Methods:

• A systematic review of case series with at least two cases of mirror syndrome was conducted.
• Databases searched included PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and CINAHL up to February 2022.
• Data extraction and quality assessment were performed independently, adhering to PRISMA guidelines.

Main Results:

• Diagnostic criteria included maternal edema (91.7%), fetal hydrops (75%), placental edema (50%), and placentomegaly (41.7%).
• Clinical presentation commonly involved maternal edema (62.2%), hypoalbuminemia (54.9%), anemia (39%), and new-onset hypertension (39%).
• Maternal complications were frequent and severe (89.4%), including postpartum hemorrhage (44.7%), with a fetal survival rate of only 7.7%.

Conclusions:

• Diagnostic criteria for mirror syndrome are inconsistent, and its presentation overlaps with preeclampsia.
• The condition is linked to substantial maternal morbidity and high fetal mortality.
• Further research into the pathogenesis of mirror syndrome is crucial for improved clinical management.