镜像综合征临床诊疗研究进展

Research progress of clinical diagnosis and treatment of mirror syndrome

镜像综合征是指继发于胎儿水肿、胎盘水肿而出现母体水肿。镜像综合征十分罕见,临床诊断经验不足,其发生率也尚不清楚。镜像综合征的病因尚不明确,目前已知包括同种免疫反应及非免疫性因素在内的多种病因可能引起胎儿水肿,进而导致母体镜像综合征的发生,但是该病的具体病理生理机制迄今尚未阐明。母体水肿是该病的主要临床表现,其他表现还有轻度贫血和血液稀释。临床上镜像综合征需与子痫前期鉴别。胎儿水肿及镜像综合征的病因学诊断对于该病的临床处理、判断预后及再发风险评估均至关重要。临床研究显示,发生镜像综合征孕妇的胎儿预后较差,胎儿及新生儿死亡率很高。临床对该病治疗方案的选择,主要取决于解决导致胎儿水肿的病因。胎儿水肿缓解后,母体水肿可随之减轻,而且胎儿存活率也随之升高。母体发生镜像综合征后,若无有效缓解胎儿水肿的措施,则建议对孕妇尽快终止妊娠。本文综述了镜像综合征的病因、诊断及治疗研究进展,为临床镜像综合征的诊断及治疗提供参考方案。

Mirror syndrome refers to maternal edema secondary to fetal edema and placental edema.Mirror syndrome is very rare,clinical diagnosis experience is insufficient,and its incidence is not clear.The etiology of mirror syndrome is not clear,at present,it is known that multiple etiologies,including homoimmune reaction and non-immune factors,may cause fetal edema,leading to the occurrence of maternal mirror syndrome,however,the specific pathophysiological mechanism of the disease has not yet been elucidated so far.Maternal edema is the main clinical manifestation of the disease,whereas other manifestations include mild anemia and hemodilution.Mirror syndrome should be differentiated from preeclampsia clinically.Etiological diagnosis of fetal edema and mirror syndrome is very important for clinical management,prognosis and risk assessment of recurrence of the disease.Clinical studies have shown that the fetal prognosis of pregnant women with mirror syndrome is poor,and the fetal and neonatal mortality is very high.The choice of clinical treatment plan for this disease mainly depends on solving the cause of fetal edema.After the fetal edema is relieved,the maternal edema can be reduced accordingly,and the fetal survival rate also increases.If there is no effective measure to relieve fetal edema after maternal mirror syndrome,it is recommended to terminate pregnancy as soon as possible.This article reviews the research progress of etiology,diagnosis and treatment of mirror syndrome,and provides a reference scheme for the diagnosis and treatment of mirror syndrome.