Pregascreen Quadruple Marker Reflex Test

• The Serum Quadruple marker test is a screening tool used in pregnancy (second trimester) to assess the risk of fetal chromosomal abnormalities. It identifies pregnancies with a higher chance of having a baby with Down syndrome, Edwards syndrome, or neural tube defects.
• If the Quadruple marker test shows a higher-than-average risk, further confirmation is recommended for a more precise diagnosis.
  • Confirmation provides peace of mind by clarifying the risk.
  • It allows parents to make informed decisions about their pregnancy management if a chromosomal abnormality is confirmed.

As per ACOG all pregnant women should be offered a prenatal screening and diagnostic test.

This test measures four markers (AFP, HCG, estriol & Inhibin-A) in the maternal blood.  NIPT or Karyotyping/FISH of amniotic fluid (any one) is used for confirmation of screen positives with consent.

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.

High levels of AFP point to neural tube defects in the foetus or there can be incomplete closure of the foetus abdomen. 
Low levels of HCG indicate a miscarriage or ectopic pregnancy. Whereas, if the levels of HCG are high this indicates multiple pregnancies. 
Low levels of estriol indicate a high risk of Down syndrome especially when the levels of AFP are low and HCG & Inhibin A are high.
Abnormal test (high-risk pregnancy) results do not always indicate a birth defect; it might be because of a variation in the estimated gestational age or other factors. A more specific screening test (NIPT)/ confirmatory test like karyotyping/ FISH are highly recommended. It is always suggested to consult your gynaecologist for any queries.