In postpubertal age, one of the most common genital tract malformations is imperforate hymen and the patient usually presents with abdominal pain of cyclical nature with palpable abdominal mass and increased frequency of micturition. We report an unusual case of a 15-year-old girl who had a history of hematocolpos for which she underwent simple hymenotomy and drainage of collected menstrual blood from the genital tract, 2 months later, she again developed similar complaints of increased frequency of micturition and some palpable masses in the lower abdomen. On further investigation, magnetic resonance imaging showed recurrent hematocolpos but with a transverse vaginal septum. For which she again underwent hymenotomy and septal excision with Z-plasty. Imperforate hymen is a rare congenital malformation of the vagina that can be treated and diagnosed easily. An adequate early management requires proper knowledge and clinical history of pain with amenorrhea in young girls for diagnosis.

Mirror syndrome, by definition, is maternal edema with fetal hydrops. Majority of the pregnancies in developing countries are complicated by preeclampsia and intrauterine growth retardation. Fetal ascites, on the other hand, is a part of spectrum of the condition under hydrops fetalis. Abnormal umbilical artery Doppler is an indicator of fetal growth retardation and not many cases are found with such diversely intermixed conditions. A 26-year-old primigravida with 36 weeks gestation by the last menstrual cycle and 34 weeks by ultrasound presented to our hospital with a history of decreased fetal movements, headache, fever, weakness, dizziness, and new-onset raised blood pressure. Her blood pressure was 164/118 and 3+ proteinuria on the urinary dipstick test. A diagnosis of preeclampsia was made. An antenatal ultrasound was performed, which showed fetal ascites, mild thickening of fetal skin, oligohydramnios with reversed umbilical artery flow but normal uterine arteries, and middle cerebral arteries. The blood pressure was controlled and she later delivered a low-birth weight baby that needed neonatal intensive care unit stay for fetal distress and abdominal distention. The baby did not survive the coming few days and died due to increasing fluid in the body cavity. The mother continued to have raised blood pressure in the postpartum period. Mirror syndrome is when the maternal pathology mirrors that of the fetus. Preeclampsia, fetal hydrops, and placental edema are the conditions lead to suspicion of it. In the case, we present, the mother had preeclampsia, and there was fetal ascites and reversed umbilical flow. The fetal and maternal outcome was in the form of intrauterine growth retardation, impending hydrops fetalis and chronic hypertension, respectively.