Double Marker First Trimester 8-13 Week (FMF Certified)

The double marker test (also known as the dual marker test) is a pregnancy screening test typically conducted between 8 and 13 weeks of pregnancy. It helps to assess the risk of certain genetic conditions in the baby, such as Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and Patau syndrome (Trisomy 13), by measuring two substances in the mother’s blood:

• Free beta-human chorionic gonadotropin (β-hCG)
• Pregnancy-associated plasma protein-A (PAPP-A)

This test is safe and does not harm the baby. It only assesses the risk of certain conditions and does not provide a confirmed diagnosis. A hard copy of an ultrasound (nuchal translucency or NT scan) report is required before booking the double marker test, as the test results are interpreted together with the ultrasound findings.

A double marker test in pregnancy is performed as a routine screening test in early pregnancy to assess the risk of genetic problems in the baby. This helps doctors make timely decisions about further diagnostic tests if needed.

This test is usually recommended for:

• Women aged 35 years and above.
• Individuals with a family history of genetic disorders.
• Women who have had a previous pregnancy with abnormalities.
• Women with abnormal results on other maternal blood tests.
• Women with abnormal results on early ultrasound findings (NT scan).
• Women who conceived through in vitro fertilization (IVF) or other assisted methods.

The double marker test is usually performed once during early pregnancy, within a specific time window:

The double marker test results help assess the risk of conditions, such as:

• Down syndrome (Trisomy 21): A genetic condition where babies may have delayed development and features such as eyes slightly slanted upwards, flat facial features, shorter height, and low birth weight.
• Edwards syndrome (Trisomy 18): A genetic condition associated with developmental issues and features such as cleft lip/palate (a gap in the upper lip or roof of the mouth), abnormal hands/feet, kidney issues, and heart defects in babies.
• Patau syndrome (Trisomy 13): A genetic condition where babies may have serious health issues and features such as cleft lip/palate, extra fingers/toes, brain abnormalities, and heart defects.

Note: This is a screening test that only assesses the risk of certain conditions. More tests are needed to understand the results clearly.

What to Expect Before the Double Marker Test

No fasting is required for a standalone Double Marker Test. You can eat and drink normally. However, if it is part of a broader package that includes fasting tests, your doctor may advise an 8 to 12 hour fast.

What to Expect During the Blood Collection

A phlebotomist cleans the skin with an antiseptic, then places an elastic band around your upper arm to make the veins easier to access. A small needle is inserted into the vein - you may feel a brief pinch. Blood is collected into a labelled tube in under a minute.

What to Expect After the Double Marker Test

A small cotton swab and bandage are placed over the site to stop any minor bleeding. You can return to normal activities immediately. Minor bruising is normal and disappears quickly. If dizzy, sit and rest for a few minutes.

The double marker test checks for two parameters:

• Free Beta-hCG: A hormone made during pregnancy that helps support the pregnancy.
• PAPP-A: A protein that helps the baby grow and supports the placenta (the organ that nourishes the baby in the womb).

Note: Before booking this test, you may need to present a hard copy of your most recent USG report (not an older one) along with the test requisition form (TRF) form filled with complete details. The result will show a risk ratio based on free β-hCG, PAPP-A, and other maternal factors (such as age, etc.).

The table below shows the double marker test values.

Important Note

• Results should always be interpreted by a qualified doctor.
• Values in test results may vary based on laboratory standards, pregnancy dates, and maternal factors (e.g., weight).
• This is a screening test that does not provide a diagnosis; it only provides risk assessment.
• For the double marker test price, please contact your local diagnostic center or refer to online healthcare platforms.

The table below shows what high or low levels in a double marker test report may indicate:

Note: A higher ratio (e.g., ≥1:10000) is considered low risk (screen negative) and indicates a lower chance of chromosomal abnormalities, though it does not completely rule them out. Likewise, a lower ratio (e.g., ≤1:250) is considered high risk (screen positive) and suggests an increased likelihood of abnormalities, for which further confirmatory tests may be recommended.

The double marker test results are always interpreted together with the NT scan report to better evaluate the risk of chromosomal abnormalities.

This test is generally considered safe; however, some possible risks and limitations are as follows:

Potential Risks and Complications (Rare)

• Mild pain at the blood draw site.
• Slight bleeding or bruising.
• Light-headedness or dizziness.

Note: If any of these do occur, they usually resolve on their own shortly.

Understanding Double Marker Test Limitations

• This is a screening test that provides a risk estimate and is not a diagnostic test.
• There is a possibility of false positive and false negative results.
• The test is more accurate when the double marker test weeks (pregnancy weeks) are calculated correctly.
• Results are more reliable when combined with NT scan findings.

If the double marker test shows a possible risk, doctors will compare it with the NT scan and may suggest further tests, such as:

• Non-Invasive Prenatal Testing (NIPT)
• Chorionic Villus Sampling (CVS)
• Amniocentesis