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About the test
What is this test done for?
Dual marker, also known as double marker test, is a blood test that measures the amount of 2 substances in the blood. Two substances evaluated are human chorionic gonadotropin (HCG) and pregnancy associated plasma protein A (PAPP-A) along with ultrasound examination.
Why is it Done?
This is a specialized blood test carried out in pregnant women in 1st trimester i.e. 9-13th week of pregnancy. In dual marker test, a combination of PAPP-A, hCG and nuchal translucency (evaluated on ultrasound) are used to assess the risk of chromosomal anomalies like Down’s syndrome and Edward’s syndrome.
When should it be performed?

This test is performed in a pregnant woman in 1st trimester (9th to 13th week of pregnancy). It helps in screening for certain genetic disorders in a baby. The genetic disorders it screens for are

  • Down’s syndrome
  • Trisomy 18 (A chromosomal abnormality) or Edward’s syndrome

This test is carried out in all women nowadays, but certain women are at greater risk of having baby with these defects, including

  • Women who are over 35 years of age during pregnancy
  • Women who are on insulin to treat diabetes
  • Women who are exposed to very high radiation
How is it done
A blood sample will be collected from a vein in your arm. No special preparations like fasting required. Along with blood sample a recent ultrasound report will be required for evaluation and calculation.

The test result of hCG is normal, if levels of hCG are 4060-165400 mIUg/mL. It means

  • Absence of Down’s syndrome
  • Absence of Trisomy 18
  • Absence of neural tube defect

The levels of hCG are low, if it is below 4000 mIU/mL. It means

  • Miscarriage
  • Ectopic pregnancy

The levels of hCG are high, if it is above 16500 ng/mL. It means

  • Down’s syndrome
  • Multiple pregnancies
  • Trisomy
  • Hydatidform mole

PAPP-A increases rapidly about 32 days after ovulation and then gradually drops down.

High levels of PAPP-A indicate Down’s syndrome.

Low levels of PAPP-A indicate Edward’s syndrome.

Very low levels (below 0.4MoM) indicate adverse obstetrical outcomes.

Other Tests
  • Quadruple Marker
    • It is a routine blood test carried out during 2nd trimester
    • It evaluates the amount of AFP, hCG, estriol and Inhibin A
    • Abnormal levels indicate neural tube defects, spina bifida, multiple pregnancies, Down’s syndrome
  • Triple Marker
    • It is a routine blood test carried out during 2nd  trimester
    • It evaluates the amount of AFP, hCG and estriol
    • Abnormal levels indicate neural tube defect, spina bifida, multiple pregnancies, Down’s syndrome
  • Pre-natal Cell free DNA screening
    • It is a highly specialized blood test that examines the cell-free DNA from the placenta and fetus
    • Abnormal results indicate
      • Down’s syndrome
      • Turner’s syndrome
      • Trisomy 18
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