Test Detail
Understanding the Test
Test Measures
Interpreting Results
FAQ's
City Price Info
Home Collection
References
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Dr. Shreya Gupta
BDS, MDS - Oral and Maxillofacial Pathology
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MBBS, MD (Pharmacology)
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Quad Marker test With Graph

Also known as Quadruple marker test, Quad marker screening
32993600 8% Off
You need to provide
Blood
This test is for
Female
Test Preparation
  1. Provide maternal Date of birth (dd/mm/yy); Last date of your menstrual cycle, Ultrasound; Number of Fetuses (Single/Twins); Diabetic status and Body Weight in Kg, IVF, Smoking & Previous history of Trisomy 21 pregnancy at the time of sample collection. It is mandatory to fill a Maternal Serum Screen requisition form at the time of sample collection.
  2. A duly filled Maternal Serum Screen requisition form (Annexure - CR/02) is mandatory. Valid between 14-22 weeks gestation (Ideal 15-20 weeks). USG report is required.

Understanding Quad Marker test With Graph


What is Quad Marker test With Graph?

A Quad Marker test With Graph is the most common blood screening test done between the 15th and 22nd week (second trimester) of pregnancy to determine whether the baby is at risk for certain birth defects. It offers valuable information to ensure the well-being of both the mother and the unborn child.

Quad Marker test With Graph test is a prenatal screening test tailored to provide expectant parents with insights into the health of the developing baby. It analyzes specific markers in the mother’s blood to assess the risk of chromosomal abnormalities, such as Down Syndrome (Trisomy 21) and Edwards Syndrome (Trisomy 18), wherein extra copies of chromosome 21 and 18 are present and affect the baby's physical and intellectual development. It also screens for neural tube defects like spina bifida (a spinal cord defect) and anencephaly (a brain defect). These birth defects can result in nerve damage, learning disabilities, paralysis, or stillbirth.

The Quad in Quad Marker test With Graph test refers to the four specific markers measured in the mother’s blood during the screening. These include Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (hCG), Unconjugated Estriol (uE3), and Inhibin A. The levels of these markers when assessed collectively help in estimating the likelihood of certain fetal abnormalities that can affect the baby’s growth and development. Timely detection of these abnormalities is vital for ensuring comprehensive prenatal care and addressing potential health problems effectively. In addition to the traditional Quad marker analysis, the inclusion of a graphical representation enhances the interpretability of results. 

A quad marker test is a screening test only and any abnormal result does not mean that the unborn baby has a birth defect or genetic condition. It only tells whether the unborn baby is at risk of developing certain abnormalities and further testing is required to confirm the diagnosis.

The decision to recommend the quad marker test is often based on maternal age, medical history, and individual risk factors for chromosomal abnormalities. Pregnant women should consult their doctor to determine the most appropriate screening or diagnostic test based on their specific circumstances. 

No special preparation is required before undergoing a quad marker test. However, it is essential for a woman to be prepared to provide informed consent before undertaking this test. The laboratory personnel will explain the purpose, benefits, and limitations of this test.

Abnormal lab test results represent only the risk but not the diagnostic outcomes. Increased risk does not mean that the baby is affected, and further tests must be performed before a confirmed diagnosis can be made. Talk to your doctor about your specific test results. 

What is Quad Marker test With Graph used for?

A Quad Marker test With Graph test is done:

  • To assess the risk of certain chromosomal abnormalities in the developing baby.

  • To detect the risk of Down Syndrome (Trisomy 21) in the developing baby.

  • To detect the risk of Edwards Syndrome (Trisomy 18) in the developing baby.

  • To detect the risk of neural tube defects like spina bifida in the developing baby.

  • Typically between the 15th and 22nd weeks of pregnancy, this offers a window for assessing specific developmental concerns in the developing baby. 

What does Quad Marker test With Graph measure?

The Quad Marker test With Graph test measures the levels of four specific markers in the blood of a pregnant woman. These markers are -

Alpha-Fetoprotein (AFP): It is produced by the developing baby. Abnormal levels may suggest the risk of neural tube defects or Down syndrome.

Human Chorionic Gonadotropin (hCG): It is a hormone produced by the placenta. Abnormal levels may suggest an increased risk of chromosomal abnormalities in the developing baby.

Unconjugated Estriol (uE3): It is a type of estrogen hormone produced by the placenta. Abnormal levels may suggest an increased risk of the developing baby being born with chromosomal abnormalities.

Inhibin-A: It is a hormone produced by the placenta. Abnormal levels may suggest an increased risk of chromosomal abnormalities.

The analysis of these four markers along with other factors like maternal age, and gestational age, helps assess the risk of certain conditions in the developing baby. The graph in Quad Marker test With Graph provides a visual representation of the levels of these markers during pregnancy. 

It is noteworthy that Quad Marker test With Graph is a screening test and any abnormal results may prompt further diagnostic testing for confirmation. Pregnant women should discuss their results and implications with their doctor. 

Interpreting Quad Marker test With Graph results


Interpretations

 

Pregnancy Weeks

AFP

HCG

Estriol

Inhibin A

14

27.20 ng/mL

40370 mIU/mL

0.37 ng/mL

208.75 pg/mL

15

32.01 ng/mL

32200 mIU/mL

0.55 ng/mL

222.90 pg/mL

16

37.67 ng/mL

25690 mIU/mL

0.76 ng/mL

194.20 pg/mL

17

44.33 ng/mL

20490 mIU/mL

1.00 ng/mL

201.30 pg/mL

18

52.16 ng/mL

16340 mIU/mL

1.25 ng/mL

196.20 pg/mL

19

61.38 ng/mL

13040 mIU/mL

1.50 ng/mL

226.90 pg/mL

20

72.33 ng/mL

10400 mIU/mL

1.76 ng/mL

253.70 pg/mL

21

85.08 ng/mL

8295 mIU/mL

1.99 ng/mL

282.10 pg/mL

22

100.02 ng/mL

6620 mIU/mL

2.30 ng/mL

292.30 pg/mL

 

 

Abnormality 

Cut off

Detection rate

False-positive rate

Neural tube defects

≥ 2.5 MoM (Multiples of median)

70-75 %

2-4 %

Down Syndrome (Trisomy 21)

1: 250

75 -80 %

5 %

Edwards Syndrome (Trisomy 18)

1:100

60 %

0.3 %

 

Reference range may vary from lab to lab*

The base of screening tests is a statistical analysis of patient’s data which includes the demographic (statistical study of populations) and biochemical (laboratory) data.

Confirmation is mandatory by amniocentesis.  

The results are illustrated in the form of a graph in the test report.

 

  • Positive quadruple marker test usually indicates that the unborn child has a high risk of neural tube defects and chromosomal disorders like Down's syndrome, Patau syndrome, etc. More specific tests like amniocentesis are then advised to make a definitive diagnosis

  • High levels of inhibin A usually indicate Down's syndrome whereas low levels might be associated with Edward's syndrome or trisomy 18. Sometimes, variable levels of inhibin A may also be present, and they are usually associated with trisomy 13 or Patau syndrome

 

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about Quad Marker test With Graph


Frequently Asked Questions about Quad Marker test With Graph

Q. What is a Quad Marker test With Graph test, and why is it important?

A Quad Marker test With Graph is a prenatal screening test that evaluates the risk of chromosomal abnormalities and neural tube defects in the developing baby, helping in early detection and appropriate management.

Q. What tests are done in a quad marker test?

A quad marker test assesses four specific biomarkers: AFP (alpha-fetoprotein), HCG (human chorionic gonadotropin), Estriol (a form of estrogen), and Inhibin-A.

Q. When can I go for a quad marker test during my pregnancy?

You can undergo a quad marker test in the second trimester i.e., between weeks 15 and 22 of pregnancy.

Q. How is a quad marker test performed, and is it safe for the baby?

The test involves a simple and safe blood draw from the pregnant woman, posing no risk to the developing baby. It is a non-invasive screening test.

Q. What chromosomal abnormalities are screened by a quad marker test?

A quad marker test primarily screens for Down syndrome (Trisomy 21) and Edwards’ syndrome (Trisomy 18).

Q. Is quad marker test only advised for women of age 35 years or more?

No, this test is not specific to women aged 35 years or more. It is recommended for all pregnant women, serving as an important test for detecting fetal abnormalities before birth.

Q. What is Down's syndrome?

Down syndrome, or Trisomy 21, is a genetic disorder caused by the presence of an extra copy of chromosome 21. It can cause various physical and intellectual challenges.

Q. What is Edwards' syndrome?

Edwards’ syndrome, or Trisomy 18, is a rare genetic disorder resulting from an extra copy of chromosome 18. It manifests in distinctive physical abnormalities including a small head, a small jaw, rocker bottom feet (a rounded sole on the bottom of the feet), etc.
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Quad Marker test With Graph test price for other cities


Price inGurgaonRs. 3299
Price inPuneRs. 3299
Price inNoidaRs. 2850
Price inGhaziabadRs. 3299
Price inBangaloreRs. 3299
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References

  1. Greene ND, Copp AJ. Neural tube defects. Annu Rev Neurosci. 2014;37:221-42. [Accessed 20 Dec. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486472/#:~:text=Neural%20tube%20defects%20(NTDs)%2C,both%20genetic%20and%20environmental%20factors. External Link
  2. Screening for Down's syndrome, Edwards' syndrome and Patau's syndrome [Internet]. NHS; 19 April 2021 [Accessed 20 Dec. 2023]. Available from: https://www.nhs.uk/pregnancy/your-pregnancy-care/screening-for-downs-edwards-pataus-syndrome/#:~:text=Combined%20test-,A%20screening%20test%20for%20Down's%20syndrome%2C%20Edwards'%20syndrome%20and%20Patau's,as%20the%2012%2Dweek%20scan. External Link
  3. Sablok A, Sharma A, Ahmed CS, Kaul A. Performance of second-trimester maternal biochemistry screening (quadruple test vs. triple test) for trisomy 21: An Indian experience. Indian J Med Res. 2021 May;154(5):716-722. [Accessed 20 Dec. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210531/ External Link
  4. Gordon S, Umandap C, Langaker MD. Prenatal Genetic Screening. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557702/ External Link
  5. Güdücü N, Görmüş U, Güner Eİ, Güzel O, Kavak ZN. Quadruple test parameters in art pregnancies. Int J Clin Exp Med. 2014 Aug 15;7(8):2319-23. PMID: 25232428; PMCID: PMC4161588. [Accessed 20 Dec. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161588/ External Link
  6. Commit to Healthy Choices to Help Prevent Birth Defects [Internet]. CDC; 28 June 2023 [Accessed 20 Dec. 2023]. Available from: https://www.cdc.gov/ncbddd/birthdefects/prevention.html External Link
  7. Institute of Medicine (US) Committee on Improving Birth Outcomes; Bale JR, Stoll BJ, Lucas AO, editors. Reducing Birth Defects: Meeting the Challenge in the Developing World. Washington (DC): National Academies Press (US); 2003. 3, Interventions to Reduce the Impact of Birth Defects. [Accessed 20 Dec. 2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222083/ External Link
  8. Boonpiam R, Wanapirak C, Sirichotiyakul S, Sekararithi R, Traisrisilp K, Tongsong T. Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: a population-based study. BMC Pregnancy Childbirth. 2020 Oct 15;20(1):621. [Accessed 20 Dec. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559175/ External Link

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