Stages of Twin to Twin Transfusion Syndrome | TTTS stage

Stages of Twin to Twin Transfusion Syndrome · Stage 1: · Stage 2: · Stage 3: · Stage 4: · Stage 5: · Connecting to Your Care · I want to:.Home…ViewAllHealthServicesWomen'sHealthMaternalFetalMedicineServicesAdvancedFetalCareFetalTherapyTwintoTwinTransfusionSyndrome-TTTSStagesSectionMenuAdvancedFetalCareFetalHeartFetalTherapyOurSpecialistsCongenitalDiaphragmaticHerniaTwintoTwinTransfusionSyndrome-TTTSRisksStagesDiagnosisandTreatmentManagementTTTSPatientStoriesForHealthcareProfessionalsGeneticCounselingPatientFormsShare:OpenShareModalPrintFacebookLinkedInTwitterEmailStagesofTwintoTwinTransfusionSyndromeCallforappointment:410-328-3865410-328-3865YoumayencounterseveraldefinitionsofTTTS.Manyoftheseconceptsarebasedonthepediatricliterature-inotherwords,theyarebasedontheraresurvivorsofuntreatedTTTS.WenowunderstandthatbabiesreportedthiswayhavethemildestorshortestformsofTTTS.Earlierdiagnosisandemphasisonprenatalassessmentmeansthatthoseoldtermshavelimitedvalue.Thismakesassessmentofpatients'risksandcomparisonoftheirresultsverydifficult.In1997,Dr.RubenQuinteroproposedasystembasedonultrasoundfindingswhichmadeassessmentmuchclearer.Theuseofthisstagingsystemhasledtogeneralagreementontheconditionofthebabiesbeforetreatmentisstarted,makingitpossibleforustocomparemodernmanagementoptionsobjectively.TheseverityofTTTSisgradedbythecharacteristicsofamnioticfluidvolume,bladderfillingandmultiplefeaturesofcardiovascularfunction,infivestages.Stage1:Polyhydramnios-verticalamnioticfluidpocket>8cmintherecipientsacANDoligohydramnios-noverticalamnioticfluidpocket>2cminthedonorsac.Theseimagesofthedonorshowreductioninamnioticfluid.Ontheleft,themembraneisacrossthebaby'schest,withsmallpocketsoffluidbelowit.Ontheright,thisbabyhasnoamnioticfluidleftandhislegsaretightlypressedagainsthisabdomen.Thefluidinthispicturebelongstohisbrother,therecipient,whohaspolyhydramnios.Stage2:Absentbladderfillinginthedonor.Thedonoronthelefthasnovisiblebladder(thecoloredlinesrepresentumbilicalarteries,oneoneachsideofthebladder,


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