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.