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Hypertens Pregnancy. 2012;31(2):211-7. doi: 10.3109/10641955.2011.638959. Epub 2011 Dec 9.

Placental origins of angiogenic dysfunction in mirror syndrome.

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  • 1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.


BACKGROUNDL: 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.


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.


Angiogenic imbalance may also be responsible for the preeclampsia-like condition seen in mirror syndrome.

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