Variable	Score
Donor
	Umbilical Artery Flow:	Normal Decreased diastolic flow Absent/reversed flow
Recipient
	Ventricular Hypertrophy:	None Present
	Cardiac Dilation:	None (CT ratio < 1/3) Mild (CT Ratio < 1/2) > Mild (CT Ratio > 1/2)
	Ventricular Dysfunction:	None (FS > 30%) Mild (FS 20-30%) > Mild (FS < 20%)
	Tricuspid Regurgitation:	None Mild > Mild
	Mitral Regurgitation:	None Mild > Mild
	Tricuspid Inflow:	Distinct E & A Fused E & A
	Mitral Inflow:	Distinct E & A Fused E & A
	Ductus Venosus Flow:	All Antegrade Absent Diastolic Flow Reverse Diastolic Flow
	Umbilical Vein:	No Pulsation Has Pulsations
	Right-sided Outflow Tract:	PA > AO PA = AO PA < AO Outflow Obstruction
	Pulmonary Regurgitation:	None Present
	Cumulative Score:
	Cardiovascular Grade:

Based on:

Rychik J, Tian Z, Bebbington M, et al. The twin-twin transfusion syndrome: spectrum of cardiovascular abnormality and development of a cardiovascular score to assess severity of disease. Am J Obstet Gynecol 2007;197:392.e1-392.e8.