Quadruple Marker Test – Price, Purpose, Preparation

Blood tests are a standard diagnostic tool during pregnancy. It is a safer option which provides a clear picture about the factors affecting the growing fetus, and allows the would-be parents and the doctors to stay informed about the fetal growth, development, and associated anomalies.

The Quadruple marker test, otherwise known as the quad marker screening, is a type of blood test done during pregnancy. During the second trimester, the procedure is prescribed to find potent anomalies or complications associated with the baby’s growth and development.

Pregnancy is a very sensitive phase in a woman’s life. With the advancements in the medical field, extensive testing now allows would-be parents to prepare themselves for the arrival of their baby. Getting a quadruple marker test is a crucial part of the pregnancy journey. Don’t skip it if you wish to keep yourself updated with your baby’s growth and development in the womb.

The quad marker test results also flag if there is a possibility of severe developmental complications in the baby, requiring further testing. Given how important the test is, knowing about it in detail enables the parents to make informed decisions during their pregnancy.

This article will explore more about the Quadruple Marker test procedure and explain the test results.

What is a Quadruple Marker test?

The Quadruple marker test is a definitive blood test prescribed during the second trimester of the pregnancy. As the name suggests, the screening looks into four (quad) factors.

These include: Alpha-fetoprotein (AFP), Human chorionic gonadotropin (HCG), Estriol, and Inhibin A.

Your healthcare provider (OBGYN) will likely prescribe the test during 15-18 weeks gestation. The procedure can be prescribed up to 22 weeks gestation too.

The screening helps identify the fetus’ risks of being born with developmental issues, neural tube defects like Spina Bifida, or chromosomal defects like Down syndrome.

Depending on the analysis of quadruple test results low risk or high risk, the doctors will suggest additional testing to confirm their suspicions.

Why is the Test Done?

The prevalence of quad marker screening has been around for a long time. It is part of prenatal care and is an important test that prepares the would-be parents for any complications that could affect the baby after their delivery.

Condition/Diagnosis for	What is it?
Down syndrome	It is a Chromosomal disorder that alters the development and intellectual ability of the newborn.
Trisomy 18	Fatal chromosomal disorder that alters the structural development in the body. It often claims the lives of the newborn by the age of 1.
Spina bifida	A type of neural tube defect that results in underdevelopment of the spinal cord and the bones of the spine.
Abdominal wall defects	It results in external protrusion of the abdominal organs through an opening in the abdomen.

Besides testing for these anomalies, your OBGYN will also prescribe a Quad marker screening if:

• You are 35 years and older
• You have previous history with delivering babies with congenital defects
• You have diabetes and insulin-related complications
• You contracted a viral infection during gestation
• You are on certain harmful medications or have been abusing drugs while pregnant

Based on these factors, the healthcare provider will assess the complications and then address the problems accordingly.

What is the Purpose of Quadruple Marker Test?

The Quadruple Marker Test, also known as the Quadruple Screen Test or Quadruple Marker Screening, is a prenatal screening test used to assess the risk of certain chromosomal abnormalities and neural tube defects in the developing fetus. It typically measures four substances in the mother's blood:

1. Alpha-fetoprotein (AFP)
2. Human chorionic gonadotropin (hCG)
3. Estriol
4. Inhibin-A

The purpose of the Quadruple Marker Test is to provide information about the likelihood of conditions such as Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), and neural tube defects like spina bifida or anencephaly. While the Quadruple Marker Test does not provide a definitive diagnosis, it helps identify pregnancies that may be at increased risk, allowing for further diagnostic testing or counseling to be offered to the parents. Overall, the test aims to provide expectant parents with valuable information about the health and development of their unborn child, empowering them to make informed decisions about their pregnancy and prenatal care.

What factors does the Quadruple Marker Test Check?

As mentioned before in brief, the quad marker screen addresses four distinct factors. The low and high levels of these individual factors depict the risks of the birth defects in the developing fetus during pregnancy.

Factor	Produced from	Quad Marker Results
Alpha-fetoprotein (AFP)Normal levels: 10-150 ng/mL (15-18 weeks)	Baby’s liver	-High levels indicate risks of neural tube defects in the baby.-Low levels indicate possibilities of Down syndrome.-Could also indicate the possibility of multiple pregnancies.
Human chorionic gonadotropin (hCG)Normal levels: 13,300–254,000 mIU/mL (13–16 weeks) to 4,060–165,400 mIU/mL (17–24 weeks)	Placenta	-High levels indicate possibilities of Down syndrome.
Unconjugated estriol (UE)Normal levels: ≤2.50 ng/mL (first trimester) and ≤9.60 ng/mL (second trimester)	Baby and the placenta	-Low levels indicate possibilities of Down syndrome.
Inhibin-ANormal levels: 180 pg per milliliter (15 weeks)	Placenta and ovaries	-High levels indicate possibilities of Down syndrome.

Remember that the quadruple test normal values, low or high values aren’t a definitive diagnosis for any of the mentioned conditions. These results allow the doctors to go for further screening to determine the estimated risks.

Much like how a positive quad screening doesn’t ascertain that a baby would suffer from Down syndrome or neural tube defects, a negative screening doesn’t guarantee that the baby would be completely safe from these complications too.

Only further testing can give additional information about the associated risks and finalize a diagnosis.

How is the Quadruple Marker Test Done?

The quad marker screening is a simple blood test. The lab technician draws the blood sample from the patient’s veins and sends it for further testing.

The procedure is 100% safe and doesn’t impose any kinds of risks to the mother’s or the baby’s health.

Also, there are no specific requirements needed for preparing for the test. The mother can get their blood drawn after eating or even following their medication. There are no imposed restrictions on the timing of the test too.

Preparation for the Quadruple Marker Test

The test requires minimal preparation. Here is what you need to follow before the test-

• No fasting- You can eat and drink normally before the test.
• Inform your doctor- Consult your doctor before the test and inform them about any medications, vitamins, or supplements you take.
• Confirm accurate pregnancy dates- Accurate pregnancy dating is important to interpret the test results correctly. Your doctor will likely confirm your due date based on your last menstrual period. 

When is the Quadruple Marker Test performed?

The Quadruple Marker Test is performed between 15 and 20 weeks of pregnancy for a few key reasons:

• Fetal development- This time frame allows for optimal analysis of the four substances measured in the test. Levels of Alpha-fetoprotein (AFP), Human Chorionic Gonadotropin (hCG), Estriol, and Inhibin-A change throughout pregnancy, and between 15 and 20 weeks, they provide the most accurate information for assessing risk.
• Decision-making window- Receiving results before 20 weeks allows ample time for further testing and informed choices if the test suggests an increased risk. This could involve diagnostic tests like amniocentesis or CVS, as well as time to seek genetic counseling and make decisions about potential outcomes.
• Minimizing risks- Performing the test earlier than 15 weeks might not provide accurate results due to incomplete fetal development. 

Risks and Complications Involved in a Quadruple Marker Test

The Quadruple Marker Test has no potential risks or complications. However, in rare cases, there might be chances of risk and complications-  

•  False-positive results
•  False-negative results 
•  Difficult decisions

Complications- 

• Miscarriage- The invasive procedures used for definitive diagnosis might have a little risk of miscarriage, especially in the first trimester.
•  Fetal injury-  The needle used in these procedures can, in rare cases, injure the placenta or fetus.
•  Infection-  These procedures carry a minimal risk of infection at the puncture site.

Why should pregnant women take the Quadruple Test?

The test is done in the first and second trimester of pregnancy to assess the risk of certain chromosomal abnormalities in the fetus, like Down syndrome, Trisomy 13, and Trisomy 18.

• Early diagnosis of chromosome issues- The test assesses the increased risk of amniocentesis or chorionic villus sampling (CVS).
• Informed decision-making- Early diagnosis can provide time for parents to make informed choices about their pregnancy and potentially prepare for future needs if the condition is confirmed.
• Improved prenatal care- In high-risk pregnancies, an abnormal Quadruple Test result can help monitor the condition more closely, potentially improving the health of both mother and baby.

• Genetic counseling- If the test suggests an increased risk, genetic counseling can be helpful for parents to understand the implications of the condition and explore their options.

What can I expect from an abnormal Quadruple Marker Test?

A normal quadruple marker test means that your fetus is less likely to be born with congenital disabilities. However, a quadruple marker test low risk means higher chances of chromosomal defects, developmental defects, and other associated complications.

If the results are abnormal, the doctor will suggest further genetic screening and laboratory testing to rule out the potential risks of birth defects in the developing fetus.

Sometimes, an abnormal quad marker screening report indicates that the fetus is older than the estimated gestation. Depending on the levels of the reports, the doctor might suggest an ultrasound, prenatal cell-free DNA screening, or amniocentesis to determine the complications in the baby before their birth.

What is the cost of the Quadruple Marker Test in India?

The quadruple marker test cost in India typically starts from INR 4500. The prices can be higher depending on the city or the laboratory in which you are getting the test done. With Redcliffe Labs, you can book the Quadruple Marker test at an starting price of Rs 3199.

Quadruple Marker Test Price in Different Cities

City Name	Discounted Price
Delhi	₹3299
Noida	₹3299
Mumbai	₹3199
Bangalore	₹3299
Kolkata	₹3299
Pune	₹3299
Lucknow	₹3600
Ahmedabad	₹3199
Hyderabad	₹3299
Chennai	₹3199
Gurgaon	₹3299
Jaipur	₹3600
Faridabad	₹3299
Indore	₹3600
Patna	₹3600

Conclusion

Being pregnant is a roller-coaster ride for the parents. However, it is better to be informed about possible risks during the pregnancy to better prepare before the baby’s arrival. A quad marker screening allows the parents and the doctors to rule out every possible risk and complication that could affect the newborn’s quality of life. If your OBGYN has prescribed a quadruple marker test, get it done for your safety and your baby’s well-being as well.

FAQs

Q: What is a Quadruple Marker Test?

A: The Quadruple Marker Test, also known as the Quad Marker or Quad Screen, is a prenatal screening test used to assess the risk of certain chromosomal abnormalities and neural tube defects in a developing fetus. It is typically performed between the 15th and 20th weeks of pregnancy.

Q: What does the Quadruple Marker Test screen for?

A: The Quadruple Marker Test screens for four specific substances in the mother's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A. Abnormal levels of these substances may indicate an increased risk of conditions such as Down syndrome, trisomy 18, or neural tube defects.

Q: How is the Quadruple Marker Test performed?

A: The test involves a simple blood draw from the mother, usually done between the 15th and 20th weeks of pregnancy. The blood sample is then analyzed to measure the levels of the four markers.

Q: Is the Quadruple Marker Test diagnostic for chromosomal abnormalities?

A: No, the Quadruple Marker Test is a screening test, not a diagnostic test. It provides an estimate of the risk of certain conditions based on the levels of the four markers. If the results indicate an increased risk, further diagnostic tests such as amniocentesis or chorionic villus sampling may be recommended for confirmation.

Q: Are false positives possible with the Quadruple Marker Test?

A: Yes, the Quadruple Marker Test can yield false-positive results, meaning it may indicate an increased risk when the fetus is actually healthy. A positive result does not confirm the presence of a chromosomal abnormality but suggests the need for further diagnostic testing to assess the actual risk.

Q: Are there any risks associated with the Quadruple Marker Test?

A: The Quadruple Marker Test itself poses no direct risks to the mother or the fetus. It is a non-invasive procedure that involves only a blood draw. However, the emotional impact of receiving abnormal results and the decisions regarding follow-up diagnostic tests should be considered.

Q: How accurate is the Quadruple Marker Test?

A: The accuracy of the Quadruple Marker Test is measured in terms of sensitivity and specificity. While it can detect a majority of pregnancies with certain abnormalities, it is not foolproof. The results are interpreted in conjunction with factors such as maternal age and gestational age for a more accurate assessment of risk.

Q: Is the Quadruple Marker Test mandatory during pregnancy?

A: No, the Quadruple Marker Test is not mandatory. It is an optional screening test, and the decision to undergo the test is a personal choice made by the expectant parents after considering their individual circumstances, values, and preferences.