Clinical management and outcomes
The treatment of choice depends on the etiology of the fetal hydrops, resolution of the fetal edema will lead to maternal recovery and it has also been shown to improve fetal survival4, 20. If the fetus cannot be treated, maternal conditions can be improved by terminating the pregnancy. Induction of labor has also been associated with survival benefit in the fetus since intrauterine fetal death represents almost 60% of deaths by Mirror syndrome.4
Many case reports suggest benefit from fetal therapy approaches administered to improve fetal hydrops. Surgical intervention in cases of sacrococcygeal teratoma, specifically minimally invasive therapy such as interstitial laser ablation and radiofrequency ablation has proven to improve fetal survival10, 21. A pleuroamniotic shut placement has also shown to improve fetal hydrops and maternal edema, allowing patients to prolong their pregnancies11, 22. The use of intrauterine fetal transfusion is another option, proven effective in cases of Mirror syndrome caused by alloimmunization23.