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Triple Marker Test


The triple marker test in pregnancy is a prenatal blood screening that measures AFP, hCG, and estriol levels. It assesses risks of chromosomal abnormalities like Down syndrome and neural tube defects.

What is the Triple Marker Test?

A triple marker test is a blood test conducted in pregnancy to check for potential chromosomal defects in the fetus. It examines thrее markers in the mother’s blood - Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (hCG), and еstriol. Usually, healthcare professionals collect blood samples from arm veins after sterilization. The blood is put into labelled vials and then taken to a diagnostic lab to check for the three levels of AFP, hCG, and estriol. If these tests are abnormal, it may indicate a higher risk of certain congenital disabilities in the to-be-born baby. Triple marker test during pregnancy helps assess the chances of chromosomal conditions like trisomy 18, neural tube defects, and Down syndrome. The doctor may suggest an amniocentesis test for confirmation if the risk is higher. The triple marker screening provides vital information to aid prenatal care decisions and prepare parents if special nееd are likely.

The triple marker test is recommended for all pregnant women, especially those with these high-risk factors:

● Advanced maternal age (over 35 years)
● Previous pregnancy affected by a birth defect
● Family history of genetic disorder
● Exposure to harmful medications/toxins
● Abnormal ultrasound findings
● History of miscarriage

As mentioned above, three different types of hormones are tested in the triple marker test, which is listed below:

· Alpha-fetoprotein (AFP)

The fetus produced the AFP (alpha-fetoprotein). Elevated AFP levels detected in the triple marker test may indicate the baby has a neural tube defect like spina bifida or anencephaly. However, inaccurate pregnancy dating is the most common cause of high AFP levels. Low AFP combined with abnormal hCG

and estriol levels may signify chromosomal abnormalities like Down syndrome (Trisomy 21) or Edwards syndrome (Trisomy 18) in the fetus.

· Estriol

Estriol is produced by the fetus and placenta. Low estriol levels, combined with low AFP and high hCG, indicate an increased chance of Down syndrome in the developing baby.

· Human chorionic gonadotropin (hCG)

The placenta generates human chorionic gonadotropin. Low hCG can indicate ectopic or non-viable pregnancies. High hCG may signify molar pregnancies or multiple gestations.

Significance of the Triple Marker Test

The triple marker test serves several important purposes during pregnancy. The test screens for possible chromosomal disorders in the fetus, including Down syndrome and trisomy 18. Further diagnostic testing can be considered based on the results if any abnormalities are suspected. This information helps healthcare providers plan appropriate prenatal care for the patient. By examining hormone levels, the triple marker test can also provide insights into whether a miscarriage or ectopic pregnancy is likely. It can also reveal the possibility of multiple gestations if hormone levels are abnormal.

When is the Triple Marker Test Prescribed?

The triple marker test is generally conducted between 15-20 weeks of pregnancy to optimize timing and accuracy. The ideal timing of a triple marker test in pregnancy is usually around 16-18 weeks gestation, which allows hormone levels to be measured most precisely. Too early, before 15 weeks, can increase false positive results. The test must be completed by 20 weeks to leave time for any follow-up diagnostic testing like amniocentesis if chromosomal abnormalities are suspected. When conducted during the optimal 15 to 20-week window, the triple marker test can provide the most accurate and actionable results to guide prenatal care.


The normal values for the triple marker test in pregnancy are: -

● AFP (alpha-fetoprotein): Less than 2.5 MoM (multiples of the median)

● hCG (human chorionic gonadotropin): 0.5 - 2.5 MoM

● Estriol: 0.5 - 2.5 MoM

● High AFP can indicate neural tube defects like spina bifida or anencephaly. It can also signify inaccurate pregnancy dating.

● Low AFP with high hCG and low estriol points to an increased risk of Down syndrome.

● Low AFP and hCG may indicate a potential miscarriage or ectopic pregnancy.

● High hCG can be a marker for molar pregnancies or multiple gestations like twins/triplets.

● Low estriol, especially with low AFP, raises the risk of Down syndrome in the fetus.

Overall, a triple marker test in pregnancy values means that high or low levels of all markers may flag chromosomal abnormalities.

Results + Next Steps

One can opt for Max Lab for a triple marker test. The triple marker test in pregnancy cost at Max Lab during the second trimester is quite affordable. Reports of false-positive results for the triple marker test in pregnancy are common. It is highly advised to see a doctor as soon as possible if the triple marker test results are unclear or show abnormal levels.

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