This rare disorder causes the mother’s body to mirror symptoms of an unhealthy foetus

The exact cause of MMS is unknown but it is believed to be related to the mother's immune system. Other conditions responsible for it are Rh isoimmunisation, foetal infections, foetal hydrops, foetal malformation or metabolic disorders.

By: Lifestyle Desk

New Delhi | May 9, 2023 07:00 PM IST

4 min read

It's important to identify the symptoms of MMS immediately to get appropriate treatment. These symptoms can overlap with other conditions such as preeclampsia, so a diagnosis is essential. (Source: Freepik)

For some women, pregnancy can come with a lot of complications — from hormonal changes, every day symptoms, to serious conditions. One among them is the maternal mirror syndrome (MMS), also known as Ballantyne Syndrome or triple edema, which is a rare pregnancy disorder in which the foetus has a severe medical condition that causes the mother’s body to mirror the same. The syndrome describes the unusual association of foetal and placental hydrops (abnormal fluid accumulation in foetus) with maternal preeclampsia (high blood pressure in pregnancy). It was first described in 1892 by John William Ballantyne. Early detection is especially critical for mirror syndrome as it can be potentially life-threatening.

Explaining further, Dr Gayathri D Kamath, Senior Consultant, Obstetrics & Gynecology, Fortis Hospitals, Bannerghatta Road, Bangalore said, “Typically, women with this condition have a clinical triad of fluid collection in the fetus, a large placenta, and similar fluid collection in the mother. The causes of MMS are diverse, but in essence, any condition that makes the baby anemic can cause MMS. These include infection of the mother with parvovirus during pregnancy, rhesus incompatibility, twin-to-twin transfusion syndrome, structural problems in the baby’s heart or lungs, and rarely, foetal tumors as well.”

Signs and symptoms

Symptoms of MMS can include severe swelling, high blood pressure, protein found in urine and excessive weight gain in a short period of time. (Source: Freepik)

It’s important to identify the symptoms of MMS immediately to start appropriate treatment. These symptoms can overlap with other conditions such as preeclampsia, so a diagnosis is essential.

Dr Kamath said, “The symptoms of MMS include swelling in the hands and feet of the mother. Some women develop features of preeclampsia with an elevation of blood pressure. The mother may complain of decreased foetal movements. When an ultrasound is performed, the foetus is found to be grossly edematous, and all the body cavities of the baby are filled with fluid. The fluid accumulates because of the foetal anemia, which is the primary requisite for MMS to manifest. If the foetal anemia is not corrected, the foetus can have a silent demise inside the uterus.”

Adding to this, she said that Rh-negative women who have been sensitised with the Rh antigen can develop antibodies that can cross the placental barrier and kill the foetal RBC, causing foetal anemia. “Foetuses with cardiac abnormalities, tumors, infection with parvovirus or cytomegalovirus or defective haemoglobin can all present with foetal anemia, and some of them can develop MMS.”

Diagnosis

There is no specific test to diagnose MMS, however, results from other tests can give appropriate diagnosis. The excess fluid in the foetus is seen on ultrasound, preeclampsia can be diagnosed on blood pressure readings and protein in the urine by a urine test.

ALSO READ | All you need to know to have a safe pregnancy (and post pregnancy care)

Treatment

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Since MMS is a rare condition, treatment can vary depending on the underlying cause. Management and treatment options include supportive care with IV fluids and anti-nausea medication. In cases where preeclampsia is severe, emergency delivery may be advised. This relieves the symptoms in a few days for the mother. The mother may also be advised strict bed rest. MMS, if detected early, is easily treatable.

Concluding, the expert said, “The key factor in the treatment of MMS is early diagnosis. If diagnosed early by an ultrasound, the foetal anemia can be corrected by foetal transfusion. Thankfully, intrauterine foetal transfusion is available in India, and many babies have been saved.”

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