A singleton pregnancy with placental chorioangioma and hydrops fetalis complicated with mirror syndrome and ritodrine-induced side effects: a case report

• Published in: BMC pregnancy and childbirth Vol. 24; no. 1; p. 213
• Main Authors: Wu, Pei-Tzu, Huang, Kun-Long, Tsai, Ching-Chang, Cheng, Hsin-Hsin, Lai, Yun-Ju, Hsu, Te-Yao
• Format: Journal Article
• Language: English
• Published: England BioMed Central 20.03.2024; BMC
• Subjects: Acute liver injury; Adult; Anemia; Blood pressure; Case Report; Case reports; Cesarean section; Cesarean Section - adverse effects; Creatinine; Dyspnea; Edema; Emergency medical care; Enzymes; Female; Fetuses; Hemangioma - complications; Hemangioma - drug therapy; Hospitals; Humans; Hydrops fetalis; Hydrops Fetalis - chemically induced; Hyponatremia; Infant, Newborn; Intensive care; Kidneys; Kinases; Liver; Mirror syndrome; Obstetric Labor, Premature - drug therapy; Patients; Placenta; Placenta chorioangioma; Preeclampsia; Pregnancy; Rhabdomyolysis; Ritodrine - adverse effects; Ritodrine hydrochloride; Syndrome; Thrombocytopenia; Tumors; Ultrasonic imaging; Uric acid; Vagina; United States > US; Ritodrine hydrochloride; Hydrops fetalis; Placenta chorioangioma; Acute kidney injury; Mirror syndrome; Acute liver injury; Rhabdomyolysis
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-024-06391-5

Ritodrine hydrochloride is a widely used beta-adrenergic agonist used to stop preterm labor in Taiwan. Many side effects causing maternal morbidity and mortality have been reported. We report a case complicated with ritodrine-induced side effects and mirror syndrome that was associated with placental chorioangioma. A 36-year-old singleton pregnant woman at 25 6/7 weeks of gestation, with an undiagnosed placental chorioangioma, underwent tocolysis due to preterm uterine contractions. Her clinical condition deteriorated, attributed to mirror syndrome and adverse events induced by ritodrine. An emergency cesarean section was performed at 27 1/7 weeks of gestation, delivering an infant with generalized subcutaneous edema. A placental tumor measuring 8.5 cm was discovered during the operation, and pathology confirmed chorioangioma. Gradual improvement in her symptoms and laboratory data was observed during the postpartum period. Identifying mirror syndrome and ritodrine-induced side effects poses challenges. Therefore, this case is educational and warrants discussion. Our case demonstrates mirror syndrome induced by chorioangioma, which is rare, and ritodrine-induced side effects. The cessation of intravenous ritodrine and delivery are the best methods to treat maternal critical status due to fluid overload.