Mirror syndrome (Ballantyne syndrome) in the practice of an obstetrician-gynecologist: A clinical case
DOI:
https://doi.org/10.37800/RM.1.2026.708Keywords:
mirror syndrome, fetal hydrops, preeclampsia, non-immune hydrops fetalisAbstract
Relevance: Mirror syndrome, also known in medical literature as Ballantyne syndrome or the “triple edema” concept, is an exceptional and extremely dangerous pathology of the gestational period. Its uniqueness lies in a specific triad: massive placental edema, non-immune fetal hydrops, and generalized maternal edema syndrome. The word “mirror” reflects the pathophysiological essence of the process, in which the maternal body begins to mirror the fetus’s critical state. In modern obstetric practice, this condition often remains unrecognized. This is because the maternal clinical picture — rapid weight gain, severe edema, and sometimes increased blood pressure – is often masked as typical preeclampsia. A lack of clinical suspicion regarding fetal and placental developmental anomalies in the early stages leads to Ballantyne syndrome being diagnosed only at the stage of critical complications.
The paper aimed to present an example of a potential strategy for reducing perinatal mortality in an infant with mirror syndrome, illustrated by a specific clinical case.
Materials and methods: The study describes a rare clinical case of mirror syndrome in a fetus, treated at the Regional Perinatal Center No. 1 (Turkestan region, Kazakhstan) in 2025.
Results: During the clinical case analysis, an increase in generalized maternal edema was identified against the background of progressive fetal hydrops and placentomegaly, which allowed for the verification of mirror syndrome. Timely recognition of the specific symptoms and prompt delivery of emergency care led to a favorable outcome for the mother: the early postpartum period showed complete regression of the edema syndrome and proteinuria, along with normalization of blood pressure.
Conclusion: A clinical analysis of the first case of mirror syndrome registered in the Turkistan region confirms that this pathology is a critical “mask” of severe preeclampsia, requiring a special diagnostic algorithm. The key factor for a successful outcome is the timely detection of the pathognomonic triad (fetal hydrops, placentomegaly, and massive maternal edema) in combination with hemodilution, which dictates the need for mandatory fetal ultrasound screening when hypertensive disorders are suspected. Given that timely delivery is the only effective method of relieving the mother’s condition, early diagnosis and multidisciplinary interaction play a leading role in reducing perinatal risks.
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Copyright (c) 2026 С.Н. Кулбаева , С.У. Джабагиева , Н.А. Жусипов , А.С. Тулетова , М.М. Мырзаханова , А.А. Ризаходжаев
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