Twin-to-twin transfusion syndrome (TTTS)

Exam relevance: in 5 of 197 board exam reports · rank 101

Specialty
Obstetrics · Pregnancy disorders
Images
Ultrasound 1
Exam relevance
5 of 197 reports · rank 101
In the app
1 flashcards · GynFuchs
Last updated
10/2026 · Dr. Pascal Bafteh
Contents
  1. Images (1)
  2. Definition
  3. Classification
  4. Keep learning in the app
  5. Further reading (selection)
  6. Cross-references

Images (1)

Twin-to-twin transfusion syndrome (TTTS) – Ultrasound: Twin-to-twin transfusion syndrome: polyhydramnios in the recipient, oligohydramnios in the donor (Photo: Zijaj L, Prifti E, Rexha Shahini A, Kashami A, Kohlberger P. (Cureus, 2026), open …Ultrasound
Twin-to-twin transfusion syndrome: polyhydramnios in the recipient, oligohydramnios in the donor (Photo: Zijaj L, Prifti E, Rexha Shahini A, Kashami A, Kohlberger P. (Cureus, 2026), open …Image: Zijaj L, Prifti E, Rexha Shahini A, Kashami A, Kohlberger P. (Cureus, 2026) · CC BY 4.0 · Source · cropped

Definition

Pathophysiology and diagnosis

  • Twin-to-twin transfusion syndrome (TTTS) occurs exclusively in monochorionic placentation due to unbalanced arteriovenous anastomoses.
  • In the donor twin, hypovolaemia leads to activation of the renin-angiotensin system.
  • The diagnosis requires the combination of oligo- and polyhydramnios, with weight discordance alone explicitly NOT being a criterion.

Classification

Quintero stages

  • In Quintero stage I, by definition, there is only a discrepancy in amniotic fluid.
  • Stage II is reached when an ultrasound scan shows that the donor's bladder is no longer visible.
  • Pathological Doppler findings, such as reversed end-diastolic flow in the umbilical artery, define stage III.

Keep learning in the app

In the GynFuchs app you can learn Twin-to-twin transfusion syndrome (TTTS) with flashcards, exam questions and image tasks (colposcopy, ultrasound, CTG) – free, in your browser or as an app.

In the app: 1 flashcards on this topic

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Further reading (selection)

  1. StatPearls: Twin-to-Twin Transfusion Syndrome (NCBI Bookshelf)
  2. DocCheck Flexikon, Fetofetales Transfusionssyndrom

Cross-references

More topics: Pregnancy disorders

Note: Learning content from the GynFuchs app (flashcards, exam questions, image cases) for medical education – not a treatment recommendation and no substitute for diagnosis or treatment decisions in individual cases. Treatment and management are deliberately not covered on this page.