Een jonge vrouw met kortademigheid op 30 weken zwangerschap

A 30-week pregnant woman, gravida 1, para 0, bloodtype A rhesus negative presented at the department of Obstetrics and Gynecology for an intrauterine transfusion. A recent check up revealed the presence of fetal anemia and hydrops due to rhesusalloimmunisation. Twelve hours after the first intrauterine transfusion, sudden dyspnea occured. Hypotension, tachycardia, tachypnea and sudden desaturation were noted on clinical examination. Biochemistry revealed normal findings, except for hemodilution. CT thorax showed findings compatible with pulmonary edema. Pre-eclampsia, HELLP (Hemolysis, Elevated Liver tests, Low Platelets), fluid embolism, pulmonary embolism, iatrogenic cause (celestone, nifedipin), transfusion related acute lung injury (TRALI) and peripartum cardiomyopathy were included in the differential diagnosis. In this case, the diagnosis of mirror syndrom was made. The presentation, pathogenesis and treatment of mirror syndrome are discussed.

Jaar van publicatie:2017