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Maternal Mirror Syndrome Masquerading as Congestive Heart Failure: A Case Report

Xu, Wen MD*; Smith, C. Tyler MD*; Binstock, Anna MD; Lim, Grace MD, MSc‡,§

doi: 10.1213/XAA.0000000000000965
Case Reports

Mirror syndrome is a rare pregnancy complication, life-threatening to mother and fetus. Increasing survival rates of congenital heart disease into reproductive age mean that complications like Mirror syndrome in this population may be more challenging to diagnose, given overlapping signs of edema in cases of heart failure exacerbation. We report a case of a pregnant woman with a history of unspecified congenital heart disease, presenting with swelling and distension, with diagnostic findings not consistent with preeclampsia. Her course was complicated by dyspnea, oliguria, and fetal hydrops. A cesarean delivery under neuraxial anesthesia was performed. We review the clinical manifestations of Mirror syndrome and discuss anesthetic and obstetric management considerations for this condition.

From the *Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Departments of Obstetrics & Gynecology, Division of Maternal Fetal Medicine

Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania

§Magee-Womens Research Institute, Pittsburgh, Pennsylvania.

Accepted for publication December 10, 2018.

Funding: Dr Lim is supported in part by the Department of Anesthesiology, University of Pittsburgh School of Medicine, and by an award from the National Institutes of Health Building Interdisciplinary Research Careers in Women’s Health (K12HD043441).

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal’s website.

Address correspondence to Grace Lim, MD, MSc, Department of Anesthesiology, Magee-Womens Hospital of UPMC, University of Pittsburgh School of Medicine, 300 Halket St, Suite 3510, Pittsburgh, PA 15213. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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