Combine screening of Pre-eclampsia & Trisomies

Combined screening of Preeclampsia and trisomy measures the Free beta HCG, PAPPa, PLGF and NT levels in the blood serum.

• The test is used to screen for patients at risk of developing PreEclampsia (PE) during pregnancy.
• The test if done early helps to prevent PE associated complications later in the pregnancy.
• Helps the clinician to start the pregnant woman on timely treatment and ensures close monitoring throughout the pregnancy.
• Helps to monitor cases at risk for foetal abnormalities, intrauterine growth restrictions etc.
• Helps to detect and rule out chromosomal anomalies and trisomies.
• Helps in the detection of neural tube defects.

• Pregnant women at risk or suspected to have foetal anomalies should ideally undergo combined PE screening between 11 and 13 weeks of pregnancy.
• Pregnant women with previous history of PE or adverse pregnancy outcomes.
• Those with family history of co-morbidities like hypertension, type 1 or Type 2 diabetes mellitus, obesity, thyroid disorders, kidney disorders etc.
• Those with an immediate family history of chromosomal abnormalities, Down’s syndrome or Edward syndrome should undergo the screening.

This test requires a blood sample. A tourniquet (elastic) band is placed tightly on the upper arm. The patient is then asked to make a fist. This helps in the build-up of blood filling the veins. The skin is disinfected before needle insertion and the blood sample is collected in vacutainer. The maternal clinical history, USG reports, TRF details and other details are mandatory.

TRF details, USG report and clinical history required.

hCG Beta Subunit, Serum

In pregnancy, hCG level rise can be correlated with gestational weeks especially in the first trimester. 

Low level may indicate: Foetal death, incomplete miscarriage, threatened spontaneous abortion, ectopic pregnancy etc. 

Pregnancy Associated Plasma Protein-A (PAPP-A) Test

The reference levels depend on the maternal and gestational age. Low levels may indicate fetal abnormalities. Low levels should be correlated with the PIGF test, USG test and clinical history for further diagnosis and risk factor calculation.

PlGF (Placental Growth Factor)

Low levels of PIGF may occur in women at risk of PE. Low levels should be correlated with the PAPP-A test, USG findings and clinical history for further diagnosis and risk factor calculation.

Trisomy 21 and Trisomy 18/13

Risk factor calculation is done to rule out chromosomal anomalies like trisomies and neural tube defects in the fetus.

Based on all the results, software dependent statistical analysis is done for Risk factor calculation. The risk factor calculated are statistical approaches and have limited diagnostic value. Results should be correlated with the clinical history and USG findings.

These are screening tests and hence further confirmatory tests may be required for an appropriate diagnosis.

• Free beta HCG test
• NT test 
• PAPPa test
• PIGF test

Beta Human Chorionic Gonadotropin (β hCG) is a hormone that is produced by the placenta during pregnancy. β hCG levels can be correlated with weeks of gestation and thus can help identify pathologic pregnancy & miscarriages.

PAPP-A is a protein produced by the placenta and important for fetal growth and development. PAPP-A is an important biomarker for pregnancy related abnormalities like premature birth, preeclampsia, intrauterine growth restriction.

PIGF is a growth factor protein produced by the placenta and released into the maternal blood. It is important for the growth and development of the foetus.

Apart from the other tests, tests to detect chromosomal abnormalities to rule out trisomy and neural tube defects are also done.