jamunjar-logo
whatsapp
cartmembermenu
Search for
"test & packages"
"physiotherapy"
"heart"
"lungs"
"diabetes"
"kidney"
"liver"
"cancer"
"thyroid"
"bones"
"fever"
"vitamin"
"iron"
"HTN"

Triple Marker-Second Trimester

Pregnancy
image

Report in 48Hrs

image

At Home

nofastingrequire

No Fasting Required

Details

Maternal serum screening performed during the second trimester (usually between 15–20 weeks of pregnancy).

₹1,499₹2,750

45% OFF

Triple Marker-Second Trimester Test Information Guide

  • Why is it done?
    • Screen for chromosomal abnormalities in the fetus, particularly Down syndrome (Trisomy 21) and Edwards syndrome (Trisomy 18)
    • Detect neural tube defects such as spina bifida and anencephaly
    • Assess risk of congenital heart defects and other fetal abnormalities
    • Evaluate pregnancies with increased risk factors including advanced maternal age (≥35 years), family history of genetic disorders, or abnormal first trimester screening
    • Performed during the second trimester, typically between 15-22 weeks of gestation, with optimal timing at 16-18 weeks
  • Normal Range
    • Alpha-Fetoprotein (AFP): Normal range typically 0.7-2.5 MoM (Multiples of the Median) at 16-18 weeks gestation; measured in ng/mL or IU/mL with specific values varying by laboratory and gestational age
    • Human Chorionic Gonadotropin (hCG): Normal range approximately 0.5-2.5 MoM; measured in mIU/mL with values decreasing as pregnancy progresses
    • Unconjugated Estriol (uE3): Normal range typically 0.7-1.3 MoM; measured in ng/mL or nmol/L with values that increase during pregnancy progression
    • Results expressed as MoM (Multiples of the Median) standardizes values across different laboratories and gestational ages; values between 0.5-2.5 MoM are typically considered low risk or negative screen
    • Combined risk assessment determined by calculating overall detection rate; typical cutoff for positive screen is risk ≥1 in 250 to 1 in 270 live births
  • Interpretation
    • Low Risk (Negative Screen): Individual risk for Down syndrome and Edwards syndrome is below the established threshold (typically <1 in 250), indicating low likelihood of chromosomal abnormality; reassuring result but does not completely exclude possibility of genetic disorders
    • High Risk (Positive Screen): Individual risk for chromosomal abnormality is above the threshold, suggesting increased probability of Down syndrome, Edwards syndrome, or neural tube defects; requires further investigation and counseling
    • Elevated AFP: >2.5 MoM suggests increased risk for neural tube defects (spina bifida, anencephaly), abdominal wall defects, or other fetal anomalies; may also indicate multiple gestations or incorrect dating
    • Low AFP: <0.7 MoM may indicate increased risk for Down syndrome when combined with elevated hCG and low uE3 in the characteristic triple marker pattern
    • Elevated hCG: >2.5 MoM associated with increased Down syndrome risk; can also indicate molar pregnancy or multiple gestations
    • Low uE3: <0.7 MoM, particularly when combined with low AFP and elevated hCG, suggests increased risk for Down syndrome and Edwards syndrome
    • Accuracy of Triple Marker screening: Detects approximately 60-65% of Down syndrome cases and 50-70% of Edwards syndrome cases; detection rate for neural tube defects is approximately 80-85%
    • Factors affecting interpretation include: accurate gestational dating (critical as markers change significantly with gestational age), maternal weight, maternal age, race/ethnicity, diabetes status, and smoking status
    • False positive rate is approximately 5% when using cutoff of 1 in 250; false negative rate is approximately 35-40% meaning some affected pregnancies will have normal results
  • Associated Organs
    • Primary Organ Systems: Fetal brain and central nervous system, chromosomal and genetic systems of developing fetus, placental tissue (source of hCG)
    • Down Syndrome (Trisomy 21): Chromosomal disorder affecting intellectual development, cardiac function, gastrointestinal system, and skeletal development; triple marker shows low AFP, elevated hCG, low uE3
    • Edwards Syndrome (Trisomy 18): Severe chromosomal disorder with multiple organ involvement including congenital heart defects, renal abnormalities, and developmental delays; triple marker shows low AFP, low hCG, low uE3
    • Patau Syndrome (Trisomy 13): Another severe chromosomal disorder; triple marker less sensitive for detection but may show abnormal marker combinations
    • Neural Tube Defects: Including spina bifida and anencephaly affecting central nervous system development; elevated AFP is primary indicator
    • Congenital Heart Defects: Structural abnormalities of the heart may be detected through abnormal marker combinations, particularly in Down syndrome
    • Abdominal Wall Defects: Including gastroschisis and omphalocele; associated with elevated AFP
    • Abnormal results may lead to psychological stress, anxiety, and need for prenatal counseling and further diagnostic testing
  • Follow-up Tests
    • Amniocentesis: Definitive diagnostic test recommended for positive triple marker screening; involves sampling amniotic fluid to analyze fetal cells for chromosomal abnormalities; typically performed after 15 weeks gestation
    • Ultrasound Examination: Detailed fetal anatomy ultrasound to visualize structural abnormalities, assess for 'soft markers' of chromosomal disorders (such as cardiac echogenic foci, choroid plexus cysts, short femur), and confirm gestational dating
    • Chorionic Villus Sampling (CVS): Alternative diagnostic test if positive screening detected and earlier diagnosis desired (typically 10-13 weeks); samples placental tissue for chromosome analysis
    • Cell-Free DNA Testing (Noninvasive Prenatal Testing - NIPT): Advanced screening test analyzing fetal DNA fragments in maternal blood; higher detection rate (>99% for Down syndrome) and lower false positive rate; can be performed from 10 weeks gestation onward
    • Genetic Counseling: Recommended for all positive results to discuss implications, risks of diagnostic testing, and available options
    • First Trimester Screening Correlation: If available, combined with second trimester markers provides integrated screening (sequential screening) improving detection rates to 85-90%
    • Repeat AFP Measurement: May be repeated if initial test inconclusive or affected by technical issues; repeat testing can confirm findings
    • Specialized Fetal Echocardiography: Detailed cardiac ultrasound if cardiac defects suspected or markers suggest increased cardiac risk
  • Fasting Required?
    • Fasting Required: No
    • Fasting is not required for Triple Marker screening as the test measures hormone and protein levels in maternal serum that are not significantly affected by food intake
    • Patient Preparation: Routine blood draw requires no special preparation; patient may eat and drink normally before test
    • Critical Timing Requirement: ACCURATE GESTATIONAL DATING IS ESSENTIAL - Test must be performed between 15-22 weeks of pregnancy, with optimal window at 16-18 weeks; incorrect dating significantly impacts result interpretation
    • Prior Documentation: Bring documentation of last menstrual period (LMP) or confirm gestational age via recent ultrasound; inform healthcare provider of accurate gestational age
    • Medications: No specific medications need to be avoided; continue all routine prenatal medications as prescribed
    • Important Clinical Factors to Communicate: Inform provider of maternal age, race/ethnicity, maternal weight, diabetes status, smoking history, and any previous abnormal screening results as these affect interpretation
    • Sample Collection: Simple blood draw via venipuncture; standard serum sample collected in tube without special handling; results typically available within 3-7 days

How our test process works!

customers
customers