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Quadruple Marker - Second Trimester

Pregnancy
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Report in 48Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Performed between 15 to 20 weeks of pregnancy (commonly at 16–18 weeks) to assess the risk of certain fetal abnormalities

₹2,499₹3,025

17% OFF

Quadruple Marker - Second Trimester

  • Why is it done?
    • Screens for chromosomal abnormalities, particularly Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and Patau syndrome (Trisomy 13) in the fetus
    • Assesses risk of neural tube defects such as spina bifida and anencephaly
    • Performed during the second trimester of pregnancy, typically between 15 and 22 weeks of gestation
    • Used as part of maternal serum screening to identify pregnancies at increased risk for genetic abnormalities
    • Recommended for pregnant individuals of all ages, especially those aged 35 or older
    • Helps guide decisions regarding further prenatal testing and counseling
  • Normal Range
    • The Quadruple Marker measures four biochemical markers in maternal blood:
    • AFP (Alpha-fetoprotein): Normal range 0.7 - 2.5 MoM (multiples of the median); levels increase with gestational age
    • hCG (Human chorionic gonadotropin): Normal range 0.5 - 2.5 MoM; steadily decreases during the second trimester
    • uE3 (Unconjugated estriol): Normal range 0.7 - 1.0 MoM; increases progressively throughout the second and third trimesters
    • Inhibin A: Normal range 0.5 - 2.5 MoM; remains relatively elevated in the second trimester
    • Combined Risk Assessment: Results are typically reported as a risk ratio (e.g., 1 in 250 risk) compared to age-matched population risk
    • Negative/Low Risk: Risk ratio greater than 1 in 270 (or other established threshold) indicates low probability of chromosomal abnormality
    • Positive/High Risk: Risk ratio less than 1 in 270 indicates increased risk and warrants further testing
  • Interpretation
    • Down Syndrome (Trisomy 21) Pattern: Elevated hCG, elevated Inhibin A, decreased AFP, and decreased uE3; increases overall risk score
    • Edwards Syndrome (Trisomy 18) Pattern: Decreased hCG, decreased AFP, decreased Inhibin A, and decreased uE3; all markers typically low
    • Patau Syndrome (Trisomy 13) Pattern: Decreased hCG, elevated AFP, and decreased uE3; variable Inhibin A levels
    • Neural Tube Defects (NTD) Pattern: Markedly elevated AFP with normal or near-normal levels of other markers; indicates increased risk for spina bifida or anencephaly
    • Factors affecting interpretation: maternal age (critical factor), weight, race/ethnicity, diabetic status, smoking history, and multiple gestations all influence marker levels and risk calculations
    • Accuracy: Detects approximately 80% of Down syndrome cases and 60% of Edwards syndrome cases with a false positive rate of 5%
    • This is a screening test, not diagnostic; positive results require confirmation with diagnostic testing such as amniocentesis or chorionic villus sampling (CVS)
  • Associated Organs
    • Primary organ systems involved:
    • Fetal chromosomal and genetic material (all cell types affected by chromosomal abnormalities)
    • Placenta (produces hCG and Inhibin A)
    • Fetal liver (produces AFP)
    • Central nervous system (assessed for neural tube defects)
    • Conditions commonly associated with abnormal results:
    • Down syndrome (Trisomy 21) - cardiac defects, intellectual disability, gastrointestinal malformations
    • Edwards syndrome (Trisomy 18) - severe developmental delays, cardiac abnormalities, renal defects, cleft palate
    • Patau syndrome (Trisomy 13) - severe malformations, polydactyly, cleft palate, holoprosencephaly
    • Spina bifida and anencephaly - neural tube defects affecting spinal cord and brain development
    • Other chromosomal abnormalities and genetic syndromes may also affect marker levels
  • Follow-up Tests
    • For positive or high-risk results:
    • Detailed ultrasound examination - comprehensive fetal anatomy scan to assess for structural abnormalities and soft markers
    • Cell-free DNA testing (NIPT) - non-invasive prenatal testing for more accurate risk assessment
    • Amniocentesis - obtaining fetal cells via needle aspiration for definitive karyotype and chromosomal analysis; typically performed after 15 weeks gestation
    • Chorionic villus sampling (CVS) - diagnostic test obtaining placental tissue earlier in pregnancy (10-13 weeks)
    • Genetic counseling - discussion of results, options, and implications for pregnancy management
    • For specific findings:
    • Elevated AFP alone - fetal ultrasound to rule out neural tube defects, multiple gestations, or incorrect dating
    • Repeat testing - may be considered if initial results inconclusive or if dating uncertain
    • Monitoring and ongoing care:
    • Regular prenatal follow-up appointments with obstetric care provider
    • Additional third trimester ultrasounds if abnormalities suspected
    • Pediatric specialty consultation if fetal anomalies confirmed
  • Fasting Required?
    • Fasting: No - fasting is not required for this test
    • The patient may eat and drink normally before the blood draw
    • Patient preparation requirements:
    • Accurate gestational age dating is critical - confirm dating via first trimester ultrasound or LMP documentation
    • Blood sample collection: simple venipuncture, typically 5-10 mL of maternal blood
    • Timing: Blood should be drawn between 15 and 22 weeks of gestation (optimal 15-20 weeks)
    • No medications need to be avoided; current medications will not affect test results
    • Inform healthcare provider of maternal medical conditions (diabetes, obesity, smoking status) as these may affect marker level interpretation
    • Ensure proper specimen labeling with maternal demographic information and gestational age

How our test process works!

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