Ante Natal Panel 1

Pregnancy

Report in 72Hrs

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No Fasting Required

Details

Basic maternal screening (CBC, blood group, HIV, syphilis, HBsAg).

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Ante Natal Panel 1 - Comprehensive Medical Test Guide

Why is it done?
- Comprehensive screening panel performed during pregnancy to assess maternal and fetal health status and identify potential risks or complications
- Screen for chromosomal abnormalities including Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and Patau syndrome (Trisomy 13)
- Assess maternal serum markers including PAPP-A and beta-hCG levels in first trimester screening
- Evaluate maternal age, weight, and nuchal translucency (NT) measurement via ultrasound for risk stratification
- Typically performed between 11 to 14 weeks of gestation as part of first trimester combined screening
- Identify high-risk pregnancies requiring further diagnostic testing or closer monitoring
- Guide clinical decision-making regarding prenatal diagnosis, counseling, and management options
Normal Range
- PAPP-A (Pregnancy-Associated Plasma Protein A): Normal range: 0.5-2.5 MoM (Multiples of the Median) at 11-14 weeks Low levels (<0.5 MoM) may indicate increased risk for chromosomal abnormalities or adverse outcomes
- Beta-hCG (Human Chorionic Gonadotropin): Normal range: 0.5-2.5 MoM at first trimester Elevated levels (>2.5 MoM) associated with increased Down syndrome risk Decreased levels may indicate other chromosomal abnormalities
- Nuchal Translucency (NT): Normal range: <3.0 mm at 11-14 weeks gestation Measurement 3.0-3.5 mm: borderline; requires further evaluation >3.5 mm: increased risk for chromosomal abnormalities and congenital heart disease
- Combined Risk Score: Low risk: <1 in 270 (or institutional cutoff) Intermediate risk: 1 in 270 to 1 in 100 High risk: >1 in 100 (indicates need for further diagnostic testing)
- Note: Reference ranges may vary by laboratory and gestational age; specific units and cutoffs should be confirmed with the testing facility
Interpretation
- Low Risk Result (Score <1 in 270): Favorable screening result indicating low probability of major chromosomal abnormalities Does not exclude possibility of abnormalities but risk is within acceptable range Routine prenatal care continues with standard monitoring
- High Risk Result (Score >1 in 100): Indicates increased risk for chromosomal abnormalities Warrants further diagnostic evaluation such as amniocentesis or chorionic villus sampling (CVS) Consider non-invasive prenatal testing (NIPT) as alternative or additional screening Detailed ultrasound evaluation recommended
- Elevated PAPP-A: Generally associated with lower risk for aneuploidy May indicate normal or multiple pregnancy
- Decreased PAPP-A (<0.5 MoM): Associated with increased risk for Down syndrome, Edwards syndrome, and Patau syndrome May indicate increased risk for intrauterine growth restriction, preeclampsia, or miscarriage
- Elevated Beta-hCG (>2.5 MoM): Classic marker for Down syndrome risk May also be seen in multiple pregnancies or molar pregnancy Requires correlation with other screening parameters
- Decreased Beta-hCG (<0.5 MoM): Associated with Edwards syndrome and Patau syndrome May indicate incorrect gestational age dating
- Increased NT Measurement (3.5-6.0 mm): Significant risk for chromosomal abnormalities, particularly Down syndrome Associated with congenital heart defects May indicate other genetic syndromes
- Severely Increased NT (>6.0 mm): High risk for chromosomal abnormalities and congenital heart disease Strong indication for diagnostic testing and detailed fetal echocardiography
- Factors Affecting Interpretation: Accurate gestational age dating: essential for correct interpretation Maternal age: older maternal age increases baseline risk Maternal weight: affects marker levels Multiple gestations: different reference ranges and interpretation criteria Race/ethnicity: some variations in marker levels Smoking status: may influence results Maternal diabetes: can affect marker levels
Associated Organs
- Primary Systems Involved: Fetal chromosomal system: evaluates genetic material integrity Placenta: source of maternal serum markers (PAPP-A, hCG) Fetal skeletal system: reflects in nuchal translucency measurement Fetal cardiovascular system: NT elevation associated with heart defects
- Chromosomal Abnormalities Detected: Down syndrome (Trisomy 21): most commonly screened abnormality Edwards syndrome (Trisomy 18): associated with severe developmental abnormalities Patau syndrome (Trisomy 13): associated with multiple congenital malformations Turner syndrome (45,X): monosomy X Other structural and numerical chromosomal abnormalities
- Associated Clinical Conditions: Congenital heart defects: associated with increased NT Intrauterine growth restriction: associated with low PAPP-A Preeclampsia: associated with low PAPP-A and adverse placental function Miscarriage risk: elevated with chromosomal abnormalities Intrauterine fetal death: increased with abnormal results Stillbirth: associated with some chromosomal abnormalities
- Potential Complications with Abnormal Results: Maternal anxiety and psychological distress pending diagnostic confirmation Need for invasive diagnostic procedures (amniocentesis/CVS) with small miscarriage risk Ethical considerations regarding pregnancy continuation or management Need for specialized fetal surveillance and management planning Birth planning for affected pregnancies (delivery location, perinatal care)
- Multisystem Involvement in Trisomies: Central nervous system: developmental delays, intellectual disability Cardiovascular system: congenital heart defects, structural abnormalities Gastrointestinal system: malabsorption issues, feeding problems Skeletal system: hypotonia, joint laxity Immune system: increased susceptibility to infections Endocrine system: metabolic dysfunction in Down syndrome
Follow-up Tests
- Recommended for High-Risk Results: Non-Invasive Prenatal Testing (NIPT/cell-free DNA): highly accurate screening test analyzing fetal DNA fragments in maternal blood; 99% sensitivity for Down syndrome Amniocentesis: definitive diagnostic test performed at 15-20 weeks to obtain amniotic fluid for karyotyping; carries small miscarriage risk (0.1-0.3%) Chorionic Villus Sampling (CVS): early diagnostic option at 10-13 weeks; slightly higher miscarriage risk than amniocentesis (0.2-0.5%)
- Detailed Ultrasound Evaluation: Level II ultrasound by maternal-fetal medicine specialist Assess for soft markers: echogenic intracardiac foci, choroid plexus cysts, mild pyelectasis Evaluate cardiac anatomy with fetal echocardiography if NT significantly elevated Assess fetal growth parameters Look for structural anomalies
- Second Trimester Screening (if not already performed): Triple screen: AFP, hCG, uE3 levels at 15-22 weeks Quadruple screen: adds inhibin A Provides independent risk assessment and detection of some cases missed in first trimester
- Genetic Counseling: Comprehensive discussion of results, risks, and options Explanation of diagnostic vs. screening tests Review of natural history of detected conditions Discussion of pregnancy management options Emotional support and decision-making counseling
- For Abnormal PAPP-A Levels: Serial ultrasound monitoring for fetal growth and placental insufficiency Blood pressure monitoring for preeclampsia development Fetal monitoring in third trimester Consideration of earlier delivery if complications develop
- Monitoring Frequency: Low risk: routine pregnancy care with standard third trimester monitoring Intermediate risk: consideration of detailed anatomy scan and possible additional testing High risk: close fetal surveillance, specialized ultrasound, and coordinated care planning After diagnostic testing confirmation: individualized monitoring based on specific diagnosis
- Fetal Echocardiography: Recommended if NT >3.5 mm Screens for structural cardiac defects associated with chromosomal abnormalities Typically performed at 18-22 weeks by certified sonographer
- Postnatal Follow-up: Neonatal screening and confirmatory testing if prenatal diagnosis confirmed Specialized pediatric evaluation Early intervention services and developmental assessment Management of associated medical conditions
Fasting Required?
- Fasting Status:No - Fasting is NOT required for the Ante Natal Panel 1
- Blood Draw Instructions: Can be performed at any time of day Food and beverages do not affect test results Non-fasting draws provide equivalent accuracy for markers tested No special dietary restrictions required
- Patient Preparation: Confirm accurate gestational age dating prior to test Bring pregnancy documentation (LMP date or prior ultrasound reports) Wear loose, comfortable clothing for ease of blood draw Stay hydrated; adequate hydration may facilitate blood collection Arrive with emotional support if desired for consultation
- Medications: No medications need to be discontinued for this test Continue all routine prenatal medications as prescribed Inform healthcare provider of all medications and supplements being taken Certain medications do not affect test accuracy
- Timing Considerations: Optimal timing: 11 weeks 0 days to 14 weeks 6 days gestation Must be coordinated with ultrasound measurement of nuchal translucency Schedule combined screening when ultrasound and blood draw can occur in same visit or within few days Do not postpone test if slightly outside ideal window; discuss timing with healthcare provider
- Additional Requirements: Accurate maternal age and weight at time of testing Accurate gestational age dating (first trimester ultrasound preferred) Documentation of multiple vs. singleton pregnancy Maternal ethnicity/race information for some laboratories using population-specific adjustments Maternal smoking status Coordination with ultrasound department for NT measurement
- Post-Draw Instructions: No restrictions after blood draw Resume normal diet and activities immediately Apply gentle pressure to draw site if minor bleeding occurs Normal bruising at draw site may develop and resolve spontaneously

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