Facharzt FMH Gynäkologie Und Geburtshilfe Practice Questions - Facharzt FMH Für Gynäkologie Und Geburtshilfe Spécialiste FMH En Gynécologie Et Obstétrique Exam

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A 28-year-old woman with a monochorionic diamniotic (MCDA) twin pregnancy presents at 19+4 weeks for routine ultrasound. The inter-twin membrane is confirmed. Twin A exhibits a deepest vertical pocket (DVP) of amniotic fluid of 1.5 cm with a non-visualized collapsed bladder. Twin B exhibits a DVP of 9.2 cm with a significantly distended bladder. Umbilical artery Doppler in Twin A demonstrates persistent absent end-diastolic flow, while Twin B has normal Doppler waveforms. According to the Quintero staging system and SGGG/ISUOG guidelines, what stage is this condition and what is the primary gold standard intervention?

Quintero Stage I; managed expectantly with serial weekly ultrasound surveillance Quintero Stage II; treated primarily with serial aggressive amnioreduction of the recipient twin's sac Quintero Stage III; treated with fetoscopic laser photocoagulation of communicating placental anastomoses (Solomon technique) Quintero Stage IV; managed with selective feticide of Twin A via cord occlusion

Correct Answer:

Quintero Stage III; treated with fetoscopic laser photocoagulation of communicating placental anastomoses (Solomon technique)

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