November 4, 2026 · American journal of obstetrics & gynecology MFM · DOI: 10.1016/j.ajogmf.2026.102190

Outcomes in Stage II twin-twin transfusion syndrome with donor intermittent umbilical artery Doppler abnormalities.

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This study compared laser surgery outcomes in monochorionic twin pregnancies with stage II TTTS, divided by whether donor umbilical artery Doppler showed intermittent absent/reversed end-diastolic flow or a normal waveform, with stage III (persistent UA-AREDF) as a comparison group. The authors asked whether intermittent UA-AREDF in stage II carries higher donor fetal demise risk, finding donor IUFD rates of 8.1% vs 7.1% (normal) vs 29.2% (stage III), and no significant increase in adjusted risk for intermittent cases (aOR 0.51, 95% CI 0.15–1.79). These findings support the original Quintero staging, which reserves stage III for persistent donor UA-AREDF only.

Raphael C Sun, Andrew H Chon, Lisa M Korst, Arlyn Llanes, Martha A Monson, Ramen H Chmait

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Outcomes in Stage II twin-twin transfusion syndrome with donor intermittent umbilical artery Doppler abnormalities.

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