Reversal of Ballantyne's syndrome by selective fetal termination in a twin pregnancy

Objectives. -We describe Ballantyne's syndrome, a severe clinical materno-fetal entity, a preeclampsia-like disease. Materials and methods. -We report the case of a woman with twin pregnancy presenting a Ballantyne's syndrome. Ultrasound examination at 22 weeks of gestation (wg), found heart abnormalities for one of the fetus. The ultrasonographic supervision revealed a fetal hydrops and at 28 wg a generalized maternal edema picture occurred. At this time, a Ballantyne's syndrome was suspected. Results. - A selective fetal termination of the affected twin was performed leading to a complete reversal of clinical and biochemical maternal picture, allowing the continuance of the pregnancy until 32 wg. Conclusion. - Our article illustrates that when the diagnosis of Ballantyne's syndrome is quickly suspected and a treatable cause can be found, it allows sometimes a prenatal management and improves the materno-fetal prognosis. (c) 2007 Publie par Elsevier Masson SAS.