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QUADRUPLE MARKER

About the test
What is this test done for?
Quadruple marker, also known as Quad Screen test, is a blood test that measures the amount of 4 substances in the blood. Four substances evaluated are alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), estriol and inhibin A.
Why is it Done?
This is a specialized blood test carried out in pregnant women in 2nd trimester i.e. 15-18th week of pregnancy (in certain cases it is done up to 20th week). In quadruple marker AFP, HCG, estriol and inhbin A are evaluated.
When should it be performed?

This test is performed in a pregnant woman in 2nd trimester (15th to 18th 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)
  • Neural tube defect and spina bifida

This test is carried out in all women, 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 with a family history of birth defects
How is it done
A blood sample will be collected from a vein in your arm. No special preparations like fasting required.
Results

The test result of AFP is normal, if levels of AFP are 10-150 µg/L. It could mean

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

The levels of AFP are low, if it is < 10 µg/L. It could mean presence of

  • Down’s syndrome
  • Trisomy 18

The levels of AFP are high, if it is > 250 µg/L. It could mean

  • Neural tube defect and spina bifida
  • Fallot’s tetralogy (heart defect)
  • Fetal demise or death of the baby inside the womb
  • Absence of part of brain and skull (anencephaly)

The test result of estriol is normal, if levels of estriol are 0.3-2.1 ng/mL. It means

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

The levels of estriol are low, if it is < 0.3 ng/mL. It means

  • Down’s syndrome
  • Trisomy 18
  • Fetal demise
  • Fetal adrenal insufficiency

The levels of estriol are high, if it is > 2.1 ng/mL. It means

  • Pending labor
  • Fetal congenital adrenal hyperplasia

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 < 4000 mIU/mL. It means

  • Miscarriage
  • Ectopic pregnancy
  • Trisomy 18

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

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

The test result of inhibin A is normal, if levels of inhibin A are < 97.5 pg/mL. It means

  • Absence of Down’s syndrome

The levels of inhibin A are high, if it is > 100 pg/mL. If levels of inhibin A and levels of hCG are high together, it means

  • Down’s syndrome
Other Tests
  • 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
  • Dual Marker
    • It is a routine blood test carried out during 1st  trimester
    • It evaluates the amount of estriol and PAPP-A (pregnancy associated plasma protein A)
    • Abnormal levels indicate neural tube defect or 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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