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Ante Natal Panel 2

Pregnancy
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Report in 72Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Extended pregnancy panel (includes thyroid, sugar tests, TORCH).

₹1,547₹2,209

30% OFF

Ante Natal Panel 2

  • Why is it done?
    • The Ante Natal Panel 2 is a comprehensive second-trimester screening test (typically performed between 15-22 weeks of pregnancy) designed to assess maternal serum markers and screen for chromosomal abnormalities and neural tube defects in the fetus
    • Primary reasons for ordering include: screening for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), neural tube defects such as spina bifida and anencephaly, and other chromosomal abnormalities
    • Part of routine prenatal care to identify pregnancies at higher risk, allowing for further investigation via detailed ultrasound, amniocentesis, or non-invasive prenatal testing (NIPT)
    • Indicated for all pregnant women as standard prenatal screening, with particular emphasis in maternal age >35 years, previous pregnancies with chromosomal abnormalities, or family history of genetic disorders
  • Normal Range
    • Alpha-fetoprotein (AFP): 15-22 weeks: 15-60 ng/mL (normal increases with gestational age); expressed as Multiples of Median (MoM): 0.7-2.5 MoM is considered normal
    • Human Chorionic Gonadotropin (hCG): 15-22 weeks: 5,000-60,000 mIU/mL; expressed as MoM: 0.5-2.5 MoM is normal range
    • Unconjugated Estriol (uE3): 15-22 weeks: 0.7-3.0 ng/mL; expressed as MoM: 0.5-2.5 MoM is considered normal
    • Overall Risk Interpretation: Risk ratio <1:270 (or lower threshold set by laboratory) indicates low risk; >1:270 indicates higher risk requiring further evaluation
    • Negative Result: Normal values for all markers with calculated risk below cutoff threshold, indicating low probability of chromosomal abnormality or neural tube defect
    • Positive or Abnormal Result: One or more markers outside normal range or risk calculation above established cutoff, suggesting increased risk for specific chromosomal or fetal abnormalities
  • Interpretation
    • Down Syndrome (Trisomy 21) Pattern: Elevated hCG (>2.5 MoM), Decreased AFP (<0.7 MoM), Decreased uE3 (<0.5 MoM); Risk calculation integrates maternal age and gestational age
    • Edwards Syndrome (Trisomy 18) Pattern: Decreased hCG (<0.5 MoM), Decreased AFP (<0.7 MoM), Decreased uE3 (<0.5 MoM); Usually associated with very low risk ratios indicating increased risk
    • Neural Tube Defects Pattern: Elevated AFP (>2.5 MoM) with normal or slightly elevated hCG and normal uE3; High AFP alone suggests increased risk for spina bifida or anencephaly
    • Factors Affecting Interpretation: Accurate gestational age dating is critical (±3-5 days accuracy ideal); Maternal age affects risk calculations; Maternal weight influences marker levels; Insulin-dependent diabetes increases AFP levels; Multiple gestations affect all marker levels differently
    • Clinical Significance: Abnormal results indicate increased statistical risk but NOT definitive diagnosis; Positive screening requires confirmation with diagnostic testing such as amniocentesis or detailed ultrasound; Results reflect population-based risk assessment (typically detects 60-70% of Down syndrome cases at 5% false-positive rate)
    • Low-Risk Results: All markers within normal range and risk below cutoff; Does not eliminate possibility of fetal abnormality but indicates substantially lower probability
  • Associated Organs
    • Primary Systems Involved: Fetal genome (chromosomes); Central nervous system (CNS); Placental function and trophoblastic production of markers
    • Chromosomal Abnormalities Associated with Abnormal Results: Down syndrome (Trisomy 21): intellectual disability, congenital heart defects, gastroenterological abnormalities, developmental delays; Edwards syndrome (Trisomy 18): severe intellectual disability, multiple congenital anomalies, cardiac defects, often lethal; Patau syndrome (Trisomy 13): severe developmental disorders, facial clefts, cardiac and renal abnormalities
    • Neural Tube Defects Associated with Elevated AFP: Spina bifida: incomplete closure of vertebral column and spinal cord; Anencephaly: absence of major portions of brain and scalp, incompatible with life; Arnold-Chiari malformation: brain tissue extends into spinal canal
    • Potential Complications from Abnormal Results: Maternal anxiety and psychological distress from abnormal screening; Need for invasive diagnostic procedures (amniocentesis) which carry small miscarriage risk (<1:300-500); Pregnancy loss if anencephaly or severe abnormality confirmed; Long-term parental and family burden if chromosomal abnormality confirmed
    • Other Fetal Conditions Associated with Marker Changes: Congenital heart defects; Intrauterine growth restriction; Preterm delivery; Intrauterine fetal demise
  • Follow-up Tests
    • For Abnormal/Positive Results: High-resolution ultrasound (detailed morphology scan) to assess fetal anatomy and identify structural abnormalities; Amniocentesis for fetal karyotyping and definitive chromosomal analysis; Cell-free fetal DNA testing (NIPT - non-invasive prenatal testing) as alternative to amniocentesis with lower miscarriage risk
    • Ultrasound Investigations: Fetal anatomy assessment (brain, heart, spine, renal system, extremities); Measurement of nuchal translucency and other markers; Assessment of amniotic fluid volume; Placental location and appearance; Umbilical artery Doppler if indicated
    • Genetic Counseling: Recommended for all abnormal results to discuss implications, diagnostic options, and management decisions; Genetic counselor reviews family history and recurrence risks
    • Amniocentesis (if indicated): Typically performed after 15 weeks gestation; Allows direct analysis of fetal cells via karyotype, microarray, or rapid aneuploidy detection; Results available in 1-2 weeks (karyotype) or same-day (FISH); Small risk of miscarriage (<1/300-500) and infection
    • For Normal/Low-Risk Results: Standard routine prenatal care continuation; Third-trimester ultrasound (typically 28-32 weeks) for fetal growth and well-being assessment; No additional testing required unless other clinical indications arise
    • Monitoring and Follow-up Frequency: If abnormal: urgent referral to maternal-fetal medicine specialist; decision on diagnostic testing within 1-2 weeks; Follow-up ultrasounds at intervals determined by findings; If normal: routine obstetric care with scheduled ultrasounds per gestational age guidelines
    • Complementary Tests: First-trimester screening markers (PAPP-A, beta-hCG) if not already performed; Maternal serum alpha-fetoprotein quantitative confirmation; Sequential or integrated screening incorporating results from multiple timepoints; Fetal echocardiography if cardiac anomalies suspected
  • Fasting Required?
    • No, fasting is NOT required for the Ante Natal Panel 2. Blood can be drawn at any time of day regardless of food or fluid intake.
    • Timing Requirements: Test must be performed between 15-22 weeks of gestation (second trimester); Accurate dating of pregnancy is essential for proper interpretation; Test may be performed 3-4 days after any first-trimester screening test without affecting results
    • Patient Preparation Instructions: No special preparation needed; Patient may eat and drink normally before blood draw; Remain hydrated; Wear loose-fitting clothing to facilitate blood draw; Bring valid identification and insurance card; Arrive early to complete any required paperwork
    • Medications - No Special Restrictions: Continue all regularly scheduled prenatal vitamins including prenatal multivitamins with folic acid; Continue prescribed medications as directed by physician; No medications need to be withheld before test; Anticoagulants or blood thinners do not require adjustment for routine blood draw
    • Special Considerations: Inform laboratory of maternal race/ethnicity as this may affect risk calculations; Report any recent infections or illnesses; Disclose insulin-dependent diabetes if present as it affects AFP levels; If on aspirin for blood thinner purposes, this does not contraindicate test; Recent transfusion should be reported as it may affect results
    • Sample Collection Details: Blood draw from antecubital vein (inner elbow); Usually requires one 5-10mL tube of serum; Minimal discomfort expected; Results typically available within 3-5 business days; Can be performed at hospital laboratory, outpatient clinic, or commercial laboratory draw station

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