Journal of Clinical Anesthesia
Volume 21, Issue 7 , Pages 521-524, November 2009

Anesthetic management of a parturient with fetal sacrococcygeal teratoma and mirror syndrome complicated by elevated hCG and subsequent hyperthyroidism

  • Spring M. McCann, MD (Resident)

      Affiliations

    • Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA
    • University of Pittsburgh School of Medicine, Pittsburgh, PA
  • ,
  • Stephen P. Emery, MD (Assistant Professor, Co-Director)

      Affiliations

    • Fetal Diagnosis and Treatment Center, Divisions of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, Pittsburgh, PA
  • ,
  • Manuel C. Vallejo, MD (Associate Professor, Director)

      Affiliations

    • Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA
    • University of Pittsburgh School of Medicine, Pittsburgh, PA
    • Corresponding Author InformationCorresponding author. Obstetric Anesthesia, Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA, 15213, USA. Tel.: +1 412 641 4260; fax: +1 412 641 4766.

Received 20 December 2007; received in revised form 18 November 2008; accepted 23 November 2008. published online 26 October 2009.

Abstract 

Mirror syndrome is a condition in which the mother "mirrors" her hydropic fetus and/or hydropic placenta. Physical and laboratory findings of mirror syndrome include generalized edema, hypertension, and proteinuria similar to preeclampsia. However, unlike preeclampsia, mirror syndrome is associated with hemodilutional anemia and fluid overload, which may progress to pulmonary edema. The anesthetic management of a parturient with fetal sacrococcygeal teratoma, hydrops fetalis, and mirror syndrome complicated by markedly elevated maternal serum human chorionic gonadotropin and subsequent clinical hyperthyroidism, is presented.

Keywords: Anesthesia, Obstetrical, Fetal sacrococcygeal teratoma, Hydrops fetalis, Mirror syndrome

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PII: S0952-8180(09)00251-7

doi:10.1016/j.jclinane.2008.11.012

Journal of Clinical Anesthesia
Volume 21, Issue 7 , Pages 521-524, November 2009