Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025
Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Behenck Gabrielle Soares, Curtois Fernanda, El Beitune Patrícia, Jimenez Mirela Foresti, Vettorazzi Janete, da Silva Marcelo Brandão, Muller Betania, Teixeira Lucas, Longo Carolina, Callado Gustavo Yano, Araujo Júnior Edward, Micheletti Talita
Аннотация
OBJECTIVE: To characterize the maternal clinical, ultrasound, and laboratory parameters, maternal and perinatal outcomes of mirror syndrome, and to discuss the role of sFlt-1/PlGF biomarkers in diagnosis and management.
METHODS: We conducted a case series including all cases of mirror syndrome diagnosed at a tertiary reference center in Brazil. Clinical, laboratory, ultrasound, and biomarker data were collected, along with maternal and perinatal outcomes.
RESULTS: Nine cases of mirror syndrome were identified, with a mean gestational age at diagnosis of 27+6 weeks. The most frequent maternal findings were lower limb edema (n=7), hypertension (n=8), and proteinuria (n=8). Ultrasound demonstrated fetal hydrops (n=7), polyhydramnios (n=6), and placentomegaly (n=7). Laboratory abnormalities included abnormal proteinuria/creatinuria ratio in 5/8 women tested, elevated 24-hour proteinuria in all 5, anemia in 7, thrombocytopenia in 3, and elevated creatinine in 1. The sFlt-1/PlGF ratio was measured in 5 women; 4 had abnormal results, with 3 above 85, all of whom developed maternal complications or fetal death. Resolution occurred after a mean of 3.4±3.6 days, due to fetal death (n=3), delivery (n=5), or fetal surgery (n=1). In one monochorionic twin pregnancy complicated by twin-anemia-polycythemia sequence, biomarker normalization after intrauterine death of the hydropic twin allowed safe prolongation of the pregnancy and term delivery of the co-twin.
CONCLUSION: Mirror syndrome should be suspected in pregnancies presenting with preeclampsia-like features in the setting of fetal hydrops or polyhydramnios. The sFlt-1/PlGF ratio may assist in differentiating mirror syndrome from preeclampsia and in identifying women at risk for adverse outcomes.
METHODS: We conducted a case series including all cases of mirror syndrome diagnosed at a tertiary reference center in Brazil. Clinical, laboratory, ultrasound, and biomarker data were collected, along with maternal and perinatal outcomes.
RESULTS: Nine cases of mirror syndrome were identified, with a mean gestational age at diagnosis of 27+6 weeks. The most frequent maternal findings were lower limb edema (n=7), hypertension (n=8), and proteinuria (n=8). Ultrasound demonstrated fetal hydrops (n=7), polyhydramnios (n=6), and placentomegaly (n=7). Laboratory abnormalities included abnormal proteinuria/creatinuria ratio in 5/8 women tested, elevated 24-hour proteinuria in all 5, anemia in 7, thrombocytopenia in 3, and elevated creatinine in 1. The sFlt-1/PlGF ratio was measured in 5 women; 4 had abnormal results, with 3 above 85, all of whom developed maternal complications or fetal death. Resolution occurred after a mean of 3.4±3.6 days, due to fetal death (n=3), delivery (n=5), or fetal surgery (n=1). In one monochorionic twin pregnancy complicated by twin-anemia-polycythemia sequence, biomarker normalization after intrauterine death of the hydropic twin allowed safe prolongation of the pregnancy and term delivery of the co-twin.
CONCLUSION: Mirror syndrome should be suspected in pregnancies presenting with preeclampsia-like features in the setting of fetal hydrops or polyhydramnios. The sFlt-1/PlGF ratio may assist in differentiating mirror syndrome from preeclampsia and in identifying women at risk for adverse outcomes.