A RARE CASE OF NON-IMMUNE HYDROPS FETALIS COMPLICATED BY MATERNAL MIRROR SYNDROME

Non-immune fetal hydrops (NIHF) and maternal mirror syndrome (MMS) represent rare and serious complications of pregnancy. Recent advances in prenatal diagnostics and obstetric management underscore the value of detailed case reporting for these conditions. Aim of the study. To describe a rare clinical case of non-immune fetal hydrops complicated by maternal mirror syndrome. Materials and Methods: A retrospective case report is presented of non-immune fetal hydrops with concurrent maternal mirror syndrome that resulted in antenatal fetal demise. The pregnancy course, diagnostic challenges, delivery details, and findings from pathological, microbiological, and virological examinations were analyzed. The study adhered to the ethical principles outlined in the Declaration of Helsinki. Case Presentation: In a primigravida at 32 weeks of gestation, ultrasound examination revealed polyhydramnios, placentomegaly, soft tissue edema, hydrothorax, ascites, macrosomia, cardiac and pulmonary hypoplasia, and increased bowel echogenicity. Laboratory investigations excluded infection and inflammation. By 34 weeks, progression of non-immune fetal hydrops led to fetal demise. Maternal manifestations of mirror syndrome emerged, including anasarca, ascites, moderate hypertension without proteinuria, and hemoconcentration. Cesarean delivery was performed and was complicated by pronounced fetal tissue edema; the fetal weight was 5250 g. Pathological examination confirmed macrosomia, non-immune fetal hydrops, and microcephaly, with no evidence of infection. Maternal mirror syndrome features resolved by postpartum day 3. Four years later, the patient delivered a healthy term infant without complications. Conclusions: Non-immune fetal hydrops complicated by maternal mirror syndrome remains uncommon. The present case, supported by follow-up data, reinforces the hypothesized central role of the placenta in the pathogenesis of these conditions. Contemporary management strategies can mitigate maternal and fetal risks, although further investigation of these rare syndromes is warranted.