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  • Title: Mirror syndrome due to anti-Jra alloimmunization.
    Author: Tanaka K, Hosoi K, Yoshiike S, Nagahama K, Tanigaki S, Shibahara J, Ohnishi H, Kobayashi Y.
    Journal: Taiwan J Obstet Gynecol; 2020 May; 59(3):456-459. PubMed ID: 32416899.
    Abstract:
    OBJECTIVE: We report a case of fetal hydrops and mirror syndrome in a pregnancy with anti-Jra alloimmunization. CASE REPORT: A 34-year-old multiparous woman (G3P2) at 29 weeks of gestation had complications which included generalized edema and mild dyspnea. An indirect Coombs test was positive for anti-Jra antibodies. A blood examination showed hemodilution and elevated human chorionic gonadotropin. An ultrasound examination showed fetal hydrops with cardiomegaly and polyhydramnios. The patient delivered a pale and edematous infant by cesarean section and laboratory tests showed that the neonate had severe anemia (Hb 4.4 g/dL). A direct Coombs test was also positive. Microscopic examination of the placenta revealed diffuse villous edema. A genetic test for the ABCG2 gene showed the homozygous point mutation c.376C > T (376TT) in the mother, while her three offsprings all exhibited 376CT heterozygosity. CONCLUSION: The potential risk of severe fetal hydrops and mirror syndrome should be recognized in pregnancies with anti-Jra alloimmunization.
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