Anesthetic management of maternal Mirror syndrome

•Mirror syndrome is a rare obstetric entity sometimes mistaken for preeclampsia.•Maternal edema can make neuraxial anesthesia potentially difficult.•The pathogenesis of Mirror syndrome is still unknown.•We report maternal anesthetic management of a case of Mirror syndrome.

Mirror syndrome (Ballantyne syndrome, triple edema, maternal hydrops, pseudotoxemia) is a rarely diagnosed condition associated with pregnancy that can be life-threatening for both the mother and fetus. There is limited literature on its pathogenesis and anesthetic management, making prevention and treatment complex. The duration of pregnancy and severity of maternal or fetal presentation often determines outcome. We describe the anesthetic considerations of a morbidly obese parturient with Mirror syndrome.