Twin-twin transfusion syndrome - stage 1

Case contributed by Dr Alexandra Stanislavsky


Second trimester pregnancy ultrasound. Twins.

Patient Data

Age: 30 years
Gender: Female

MCDA twin pregnancy. The amniotic membrane closely envelops twin 2, due to unequal distribution of amniotic fluid (twin 1 polyhydramnios with DVP 15.4; twin 2 oligohydramnios with DVP 1.6). This is diagnostic of twin-to-twin transfusion syndrome.

Other observations relevant to staging of TTTS are:

  1. donor twin bladder is visible
  2. normal dopplers in both twins
  3. no features of hydrops in either twin
  4. no features of fetal demise.

Hence, this is stage 1 TTTS.

Limited images of fetal morphology and membranes demonstrate no other abnormality.

Twin 2 is smaller but not growth restricted. EFW discrepancy of 15% is within normal limits.

Case Discussion

Typical oligohydramnios-polyhydramnios appearance of twin-twin transfusion syndrome (TTTS) - stage 1. Note the "stuck" appearance of the oligohydramnios (donor) twin. 

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Case information

rID: 68669
Published: 10th Jun 2019
Last edited: 14th Aug 2019
System: Obstetrics
Tag: twins
Inclusion in quiz mode: Included

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