Fetal Health Foundation Medical Board of Directors member Dr Ruben Quintero has given us permission to share his video about the classifications he proposes for the stages of TTTS, which is useful in understanding the severity of a Twin to Twin Transfusion Syndrome diagnosis.

Quintero TTTS Staging System

Stage I: The fetal bladder of the donor twin remains visible on ultrasound.

Stage II: The bladder of the donor twin is not visible on ultrasound.

Stage III: Doppler studies in either twin are critically abnormal fetal. These include: absent or reverse end-diastolic velocity (AREDV) in the umbilical artery, absent or reverse flow in the ductus venosus, or pulsatile flow in the umbilical vein.

Stage IV: Fetal hydrops is noted.

Stage V: Demise of one or both twins.

Learn more about Twin to Twin Transfusion Syndrome

Read stories of families who have had a TTTS diagnosis.