Twin to twin transfusion syndrome (TTTS)

---

Figer-1

📄 Report Sample Line- Twin to twin transfusion syndrome (TTTS)
shows extension of the placental tissue into the base of the inter twin membrane (the lambda sign). shows decreased fluid around the donor (oligohydramnios <3cm deepest vertical pocket), stuck to the wall of the myometrium and increased fluid around the recipient (polyhydramnios >6cm deepest vertical pocket). Size of donor twin smaller than recipient. Monochorionic diamniotic twin pregnancy shows evidence of intertwin fluid discordance. while the recipient twin has a distended bladder and signs of cardiac strain. These findings are consistent with Twin-to-Twin Transfusion Syndrome (TTTS).


Conclussion: 📋 Sonographic findings indicate Twin-to-Twin Transfusion Syndrome (TTTS), characterized by amniotic fluid discordance and hemodynamic imbalance between donor and recipient twins in a monochorionic diamniotic pregnancy. Donor twin exhibits features of volume depletion, while the recipient twin shows signs of volume overload. The findings correspond to Quintero Stage II
Recommendation: Fetal echocardiography for recipient twin to assess cardiac function and risk of hydrops.

Quintero Staging System for TTTS

Stage	Sonographic Findings	Key Features
Stage I	– Oligohydramnios in donor twin (DVP < 2 cm) – Polyhydramnios in recipient twin (DVP > 8 cm) – Visible bladder in donor twin	Earliest sign with preserved urine output in donor
Stage II	– Same fluid discordance as Stage I – Bladder not visible in donor twin	Suggests worsening hypovolemia in donor
Stage III	– Abnormal Dopplers in either twin:   • Absent or reversed end-diastolic flow in UA   • Reversed flow in DV   • Pulsatile flow in UV	Indicates fetal hemodynamic compromise
Stage IV	– Hydrops fetalis in one or both twins	Severe TTTS with systemic compromise
Stage V	– Intrauterine demise of one or both twins	Final stage with fetal death