Quintero staging is used for:
Ans. A. Twin to twin transfusion syndromeTwin Twin Transfusion Syndrome: TttsOccurs in monochorionic diamniotic twin gestation resulting from unidirectional flow through deep arteriovenous anastomoses in the shared placenta. In this syndrome blood is transfused from a donor twin to its recipient sibling such that the donor may eventually become anemic and its growth may be restricted. In contrast, the recipient becomes plethoric, develop circulatory overload manifest as hydrops, polycythemic, may develop hyperviscosity and Occlusive thrombosis is another concern. Finally, polycythemia in the recipient twin may lead to severe hyperbilirubinemia and kernicterus.TTTS is diagnosed based on two criteria:(1) presence of a monochorionic diamniotic pregnancy(2) hydramnios defined if the largest vertical pocket is 8cm in one twin and oligohydramnios defined if the largest vertical pocket is 2cm in the other twin.TTTS is typically staged by the Quintero (1999) staging system:Stage I--urine is still visible sonographically within the bladder of the donor twin.Stage II--criteria of stage I, but urine is not visible within the donor bladder.Stage III--criteria of stage II and abnormal Doppler studies of the umbilical artery, ductus venosus, or umbilical vein.Stage IV--ascites or frank hydrops in either twin.Stage V--demise of either fetus.Treatment - laser ablation of the vascular anastomoses
Twin to twin transfusion syndrome
Twin reversed arterial perfusion
Discordant twins
Monoamniotic twins
Multiple Pregnancy