Our team uses the Quintero staging system to figure out the severity of TTTS on a scale of one to five. Five is the most serious.

Stage I: One baby has too much fluid and the other baby does not have enough fluid.

Stage II: Cannot see the bladder fill in the donor fetus on ultrasound.

Stage III: Abnormal blood flow through the umbilical cord or fetal vessels around the heart for one or both babies.

Stage IV: An abnormal fluid collection in more than one body cavity, also known as hydrops. This can happen in one or both twins.

Stage V: The death of one or both babies.

Using the results of the fetal echocardiography, we also rank the severity of the recipient fetus’ heart condition as mild, moderate or severe. After the test results are available, the patient meets with members of the team. This team includes a maternal-fetal medicine specialist, a surgeon and a nurse coordinator. We spend as much time with the patient and family in this meeting as needed. The goal is to explain the test results and create a treatment plan.