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Case Reports
. 2023 Jul 4;15(7):e41357.
doi: 10.7759/cureus.41357. eCollection 2023 Jul.

Fetal Inferior Vena Cava Thrombosis Associated With Non-Immune Hydrops Fetalis and Maternal Mirror Syndrome

Kimberly M Foxworthy  1 , Eneka Lamb  1 , Alexandria Weymon  1 , Emily Roloff  2 , Jessica Garcia De Paredes  2 , Jamie Frost  3 , Vivian C Romero  2
Affiliations
Case Reports

Fetal Inferior Vena Cava Thrombosis Associated With Non-Immune Hydrops Fetalis and Maternal Mirror Syndrome

Kimberly M Foxworthy et al. Cureus. .

Abstract

Prenatal assessment of the inferior vena cava (IVC) should be considered in pregnancies with atypical presentations of fetal ascites and placentomegaly. We examine a case of a 25-year-old gravida 2 para 1 type 1 diabetic female at 29 and 4/7 weeks' gestation. Ultrasound (US) showed fetal ascites and placentomegaly with increased middle cerebral artery peak systolic velocity (MCA-PSV) suspicious of fetal anemia. Cordocentesis with intrauterine transfusion briefly resolved the fetal ascites, though the mother developed pulmonary edema and pleural effusion, suggestive of mirror syndrome. On US, fetal ascites returned and progressed to non-immune hydrops fetalis, prompting delivery. Neonatal US revealed a heterogenous and calcified thrombus within the IVC.

Keywords: fetal ascites; hydrops fetalis; inferior vena cava thrombosis; maternal mirror syndrome; non-immune hydrops fetalis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Transverse view of the fetal abdomen at the level of the liver (Figure 1A) and below the liver (Figure 1B) demonstrating fetal ascites (yellow arrows) at 29 and 4/7 weeks' gestation.
Figure 2
Figure 2. Axial (Figure 2A) and coronal (Figure 2B) views of the fetal abdomen demonstrating recurrent ascites (solid arrow) and skin edema (hollow arrow) at 30 and 3/7 weeks' gestation.
Figure 3
Figure 3. Long axis (Figure 3A) and transverse axis (Figure 3B) ultrasound images on day of life 13 with color Doppler showing a peripherally calcified, expansile, occlusive thrombus (yellow arrows) within the inferior vena cava. Note the persistent ascites.
Figure 4
Figure 4. Long axis ultrasound images at 29 and 4/7 weeks' gestation showing a calcified thrombus (yellow arrow) within the inferior vena cava and fetal ascites.
See this image and copyright information in PMC

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