Quintero Staging
Twin-to-twin transfusion syndrome
Clinician mode
Low risk
Stage 1
Poly/oligohydramnios sequence, bladder still visible in donor
- Stage II–IV before 26/40 → fetoscopic laser (Solomon technique) is treatment of choice.
- Refer to fetal medicine centre urgently in any MCDA twin with poly/oligo mismatch.
Reference range
I: DVP >8 (recipient) / <2 cm (donor) · II: bladder absent · III: abnormal Dopplers · IV: hydrops · V: demise
Common pitfalls
- Stage does not predict outcome linearly — Dopplers matter most.
- MCDA twins need 2-weekly scans from 16/40.