Pregnancy is a vital period for tracking maternal and fetal well-being. A key screening during the second trimester is the Quadruple Marker Test. This blood analysis evaluates the potential risk of chromosomal abnormalities and neural tube defects in the fetus.

This blog will help you understand what the Quadruple Marker Test is, when to take it, its normal range, accuracy, and its significance.

What Is the Quadruple Marker Test?

The Quadruple Marker Test is a blood screening for pregnant women that assesses the risk of certain fetal genetic conditions. It detects four substances (important markers) made by the fetus and placenta that are present in the mother’s bloodstream.

The Four Markers Include:-

Alpha-fetoprotein (AFP):

Alpha-fetoprotein is a protein produced by the fetal liver that circulates in the mother’s bloodstream during pregnancy. Elevated AFP levels may signal neural tube defects such as spina bifida, whereas low levels could be linked to chromosomal disorders like Down syndrome.

Human chorionic gonadotropin (hCG):

Human chorionic gonadotropin (hCG) is a hormone generated by the placenta that is crucial for sustaining pregnancy. Higher hCG levels are frequently associated with a greater risk of chromosomal disorders, especially Down syndrome.

Unconjugated estriol (uE3):

Unconjugated estriol (uE3) is a form of estrogen made by the fetus and placenta. Low uE3 levels may indicate chromosomal abnormalities or fetal development issues.

Inhibin A:

Inhibin A is a protein hormone produced by the placenta. Elevated levels of inhibin A, when considered together with AFP, hCG, and uE3, enhance the accuracy of detecting Trisomy 21 (Down syndrome).

What Condition Can Be determined with the Quad Marker Test?

The quadruple marker test evaluates AFP, hCG, uE3, and inhibin A levels in the mother’s blood. These biochemical markers are used to estimate the risk of significant chromosomal abnormalities and structural birth defects in the developing fetus, including the following:

Down’s syndrome (Trisomy 21):

A chromosomal disorder resulting from an additional copy of chromosome 21. It can cause developmental delays, intellectual disabilities, and a range of health issues, including heart defects and hormonal problems.

Edward’s syndrome (Trisomy 18):

Results from an extra copy of chromosome 18, which is linked to severe developmental delays and various physical abnormalities. Unfortunately, there is no cure, and the condition often leads to death before birth or within the first year of life.

Abdominal wall defects:

These congenital disabilities involve the fetus’s intestines or other abdominal organs protruding through an opening in the abdominal wall, typically near the belly button. They require quick medical assessment and often surgical repair after birth.

Spina bifida:

Spina bifida is a neural tube defect that occurs when the fetal spinal cord fails to develop or close properly early in pregnancy. This condition can lead to complications, including weakness or paralysis of the lower limbs, problems with bladder and bowel control, and learning difficulties.

Quadruple Marker Test: Normal Range And Test Results

A normal or low-risk outcome for the Quadruple Marker Test typically falls within these ranges:

Note: MoM (Multiple of the Median) is a standardized value for interpreting test results. A MoM of 1.0 equals the weekly average. Values below 1.0 are below average; above 1.0 are above.

Key Points

Not Diagnostic:

The quadruple marker test is a screening, not a diagnostic, test. A positive or high-risk result does not confirm a birth defect in the baby; it simply suggests that additional diagnostic tests, like amniocentesis, might be advised.

Accuracy:

The test can detect roughly 75–80% of Down syndrome cases and has a false-positive rate of approximately 4–5%.

Timing:

For reliable results, the test is best between 16 and 18 weeks of pregnancy, but it can be done slightly outside this window if needed.

Disclaimer:

Test results must always be interpreted by a qualified healthcare professional, taking into account the mother’s medical history and the overall progress of the pregnancy.

What Does The Result Mean

Negative Result

A normal or negative quadruple marker test result suggests a low risk of chromosomal abnormalities. Usually, no further testing is required, and routine prenatal care proceeds as normal.

Positive Result

A positive or abnormal result indicates increased risk of chromosomal abnormalities or other fetal issues. It does not confirm a problem with the baby but suggests that additional tests, like a detailed ultrasound, genetic counseling, or definitive diagnostic procedures, are necessary.

Importance of the Quadruple Marker Test

This test helps identify pregnancies that may require additional diagnostic testing. Although it doesn't confirm a condition, it:

Suppose she had a viral infection during pregnancy if she had been exposed to high levels of radiation.

Who should go for the quadruple marker test?

The quadruple marker test is a routine prenatal screening recommended for all pregnant women during the second trimester. It becomes especially important in certain circumstances where the risk of fetal abnormalities is higher, such as:

• If the pregnant woman has a family history of birth defects or genetic disorders.
• If the woman is age 35 or older when she gives birth.
• If a pregnant woman has used medications or drugs that could be potentially harmful during pregnancy.
• If she has diabetes that requires insulin treatment.
• If she has had a viral infection while pregnant.
• When subjected to high radiation levels

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