Reversal of Ballantyne syndrome by selective second-trimester fetal termination. A case report

Abstract

Background: Ballantyne syndrome (mirror syndrome, triple edema) describes the unusual association of fetal and placental hydrops with maternal preeclampsia. In most cases, the poor fetal prognosis and associated maternal risks warrant delivery regardless of gestational age. We used novel therapy for Ballantyne syndrome in a twin pregnancy.

Case: Ballantyne syndrome occurred at 16 weeks' gestation due to severe, unexplained hydrops in one of dichorionic twins. Selective termination of the affected fetal twin resulted in reversal of the preeclamptic findings in the mother, and the surviving twin was born uneventfully at term.

Conclusion: This case strengthens the association of fetal and placental hydrops with preeclampsia and suggests selective fetal termination for Ballantyne syndrome due to hydrops in one of multichorionic fetuses.