Atrial fibrillation with rapid ventricular response as a maternal presentation of mirror syndrome: a case report

Case Reports

doi: 10.1016/j.crwh.2022.e00469.

eCollection 2022 Oct.

Affiliations

¹ Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
² Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
³ Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

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Case Reports

Elena HogenEsch et al.

Case Rep Womens Health.

2022.

doi: 10.1016/j.crwh.2022.e00469.

eCollection 2022 Oct.

Affiliations

¹ Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
² Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
³ Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

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Abstract

Mirror syndrome is the phenomenon of fetal hydrops causing maternal edema and weight gain. Here, we report a case of arrhythmia as the primary maternal symptom. A 36-year-old woman, G2P1001, at 34.5 weeks of gestation presented with new-onset fetal hydrops combined with maternal weight gain and edema. She developed atrial fibrillation with rapid ventricular response; cardiac workup was unremarkable. Rate control was achieved with diltiazem. She underwent delivery and reverted to normal sinus rhythm on post-operative day 1. Volume overload causes atrial wall stress and neurohormonal changes that may trigger atrial fibrillation. Optimization with rate control facilitated good maternal and fetal outcomes in this case.

Keywords:

AF, atrial fibrillation; Atrial fibrillation; CHF, congestive heart failure; CMV, cytomegalovirus; ECG, electrocardiogram; Maternal arrhythmia; NIFH, non-immune fetal hydrops; NSR, normal sinus rhythm; Nonimmune fetal hydrops.

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