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Case Report

Placental Origins of Angiogenic Dysfunction in Mirror Syndrome

Kristin BixelDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD,

Michelle SilasiDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD,

Carolyn M. ZelopDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD,

Kee-Hak LimDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD,

Zsuzsanna ZsengellerDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD,

Isaac E. StillmanDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

, MD &

Sarosh RanaDepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USACorrespondence[email protected]

, MD show all

Abstract

Background. Mirror syndrome is characterized by preeclampsia-like syndrome in pregnancies complicated by fetal hydrops. We describe a case of mirror syndrome associated with angiogenic dysfunction in maternal plasma and the placenta. Case. A pregnant patient with known fetal hydrops presented at 22 weeks gestation with features of severe preeclampsia. Measurements of plasma anti- and proangiogenic factors were consistent with a profound antiangiogenic state. Immunohistochemistry of the placenta for antiangiogenic proteins showed a pattern similar to that seen in patients with severe preeclampsia. Conclusion. Angiogenic imbalance may also be responsible for the preeclampsia-like condition seen in mirror syndrome.

Keywords

ACKNOWLEDGMENT

SR is supported by Harvard Diversity and Community Partnership Faculty Fellowship Award.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Placental Origins of Angiogenic Dysfunction in Mirror Syndrome

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Placental Origins of Angiogenic Dysfunction in Mirror Syndrome

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