Clinical Presentation and Outcome of 10 Cases of Mirror Syndrome [3P]
Bibliographic record
Abstract
INTRODUCTION: Mirror syndrome, or Ballantyne’s syndrome, is a rare diagnosis with only 113 cases described in the literature. It is mainly characterised by maternal symptoms similar to preeclampsia in the setting of fetal hydrops. We identify 10 additional cases and provide a review of the maternal presentation, biochemical findings and perinatal outcome. METHODS: We performed a retrospective chart review of all cases of fetal hydrops from two tertiary centers in Winnipeg, Canada between 2000 and 2016. There were 276 cases of fetal hydrops during this period, of which 10 cases satisfied the criteria for Mirror syndrome. RESULTS: We report 10 cases of Mirror syndrome. The majority (80%) of women were multiparous. The mean gestational age at diagnosis was 23 weeks 4 days +/- 4 days and the mean gestational age at delivery was 25 weeks +/- 5 days. The most common clinical findings included hypertension, edema and placentomegaly. The most common laboratory findings included hypoalbuminemia (mean 20 7 gm/L), elevated uric acid level (mean 375 µmol/L) and anemia (mean hemoglobin 10g/dL). Half of the fetuses were stillborn and 40% of pregnancies resulted in neonatal deaths. Congenital anomalies were diagnosed in half of the pregnancies. CONCLUSION: Mirror Syndrome is likely under-diagnosed. Acute hemodilution, hypoalbuminemia and hyperuricemia might be early indicators for the diagnosis. Delivery is the treatment of choice and maternal symptoms usually resolve within few days after delivery. Fetal outcome is poor but early recognition may potentially avoid maternal morbidity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".