Mirroring preeclampsia: the molecular basis of Ballantyne syndrome.

The purpose of this article was to further elucidate the pathophysiology of Mirror (Ballantyne) syndrome within the context of known biomarkers for preeclampsia. This novel insight from clinical practice involved a case of post-twin-to-twin transfusion syndrome-laser hydrops in an ex-donor twin, corroborated by histopathologic placental territory edema and maternal sequelae of Mirror syndrome. We serially measured the levels of activin A, follistatin, endothelin-1 (ET-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), soluble fms-like tyrosine kinase 1 (sFlt), and von Willebrand factor (vWF) in the maternal serum from disease evolution through to recovery.

Discordant retinopathy of prematurity in twin anemia-polycythemia sequence.

We report the case of severe retinopathy of prematurity (ROP) in the donor twin with twin anemia-polycythemia sequence managed with the novel treatment of intrauterine blood transfusions. The fellow polycythemic twin was managed with intrauterine venesection and developed only mild ROP. Thus, despite intrauterine improvement of the twins' hemodynamic conditions, the risk of developing severe ROP remained in the donor twin.