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What is Quadruple Marker Test: Parameters, Uses, Preparation, Procedure and Cost

What is Quadruple Marker Test: Parameters, Uses, Preparation, Procedure and Cost

What is Quadruple Marker test? Quadruple marker test also known as Quad test, is a specific type of blood test that is performed in the second trimester of pregnancy during 15-21 weeks of gestation. However, the most...

What is Quadruple Marker test?

Quadruple marker test also known as Quad test, is a specific type of blood test that is performed in the second trimester of pregnancy during 15-21 weeks of gestation. However, the most accurate results are seen during 16-18 weeks of gestation.

It is non-invasive, painless, rapid and safe technique for the screening and evaluation of chromosomal abnormalities or neural tube defects in the developing fetus during pregnancy. It is considered as a stand-alone test if screening is required for the first time in the second trimester or if first trimester screening is not available.

Parameters measured in this test includes:

  1. Maternal Serum AFP (Alpha-fetoprotein)
  2. Beta-hCG (human chorionic gonadotropin)
  3. Unconjugated Estriol (Estrogen or E3)
  4. Inhibin-A.

It is important to note that quadruple marker test is a screening test and not a diagnostic or confirmatory test for the detection of chromosomal anomalies or neural tube defects. If the test results are found to be abnormal then your health care provider will proceed further for diagnostic testings.

Other names of Quadruple marker test:

  • Quadruple screen test.
  • Quadruple test.
  • Quad test.
  • Quad screen.
  • Quad Marker Screen.

Why Do I Need a Quadruple Marker Test?

Quadruple marker test is not a mandatory test for every pregnant woman. Your obstetrician may recommend a quadruple marker test for screening purpose, in case you have high risk factors for chromosomal abnormalities or neural tube defects such as:

  • Maternal age >35 years.
  • Family history of chromosomal anomalies.
  • History of radiation exposure.
  • Occupational exposure to toxins.
  • History of chromosomal abnormality in previous child.
  • History of neural tube defects in previous childbirth.
  • History of chronic smoking.
  • Chronic diabetic mother.
  • Maternal obesity.
  • Maternal folate deficiency.
  • Seizure disorder in mother.
  • Viral infections during pregnancy.
  • Maternal intake of certain drugs such as Valproate, Carbamazepine etc.
  • Inconclusive results of double marker test or 1st trimester scans.

What Are the Uses of Quadruple Marker Test?

Quadruple marker test is used as a second trimester screening test for the evaluation of the following conditions:

  • Down syndrome: It is a genetic disorder which is characterized by an extra copy of chromosome number 21. Thus, it is also known as Trisomy 21.
  • Edward’s syndrome: It is a genetic disorder which is characterized by an extra copy of chromosome number 18. Thus, it is also known as Trisomy 18.
  • Neural tube defects (NTDs): In developing embryo, neural tube is the early precursor to the brain and spinal cord that constitutes the central nervous system. Neural tube defect is defined as failure of proper closure in the neural tube of the baby. It includes:
    1. Anencephaly (Absence of major part of cranial vault and brain).
    2. Spina bifida (Defect in spine or spinal cord).
    3. Encephalocele (Protrusion of brain through the skull bone).
  • Abdominal wall defects: It is a congenital defect in which there is an opening in the abdominal wall of baby through which the abdominal visceral organs such as intestine, liver or stomach protrude or herniate outside. It includes:
    1. Omphalocele: Midline defect in the abdominal wall and the protruded contents are covered by a sac like structure.
    2. Gastroschisis: Abdominal wall defect which is seen usually on the right side of umbilicus and the herniated contents are not covered by any sac.

How Do I Prepare for Quadruple Marker Test?

Follow these simple steps if you are planning for a quadruple marker test:

  • Take an appointment: Fix an appointment for in a diagnostic lab having the facility of quadruple marker test to avoid waiting at the time of test or to avail home sample collection.
  • Food: You can take your usual meals. Fasting is not required for quadruple marker test if done alone.
  • Medications: Inform your doctor about all the drugs and supplements that you are currently taking. Certain drugs may alter the test result. Your doctor may advice some modifications before the test if required.
  • Take a company: Get accompanied with a family member or friend to have physical and mental support.

What Is the Procedure for Quadruple Marker Test?

The procedure of quadruple marker test includes the following steps:

  • First a torniquet will be tied around your arm.
  • Then a cotton swab soaked with 70% alcohol is used to clean/disinfect the injection site before needle insertion.
  • Then a small needle will be inserted in the vein of your arm and required amount of blood is withdrawn from it and collected in a test tube.
  • Then the needle is removed and an adhesive sticker is placed on the puncture site to prevent it from infections.
  • Sample is sent to laboratory for further processing and testing.

Price of Quadruple Marker Test in Delhi?

Cost of quadruple marker test depends upon many factors such as city and locality. Different diagnostic labs charges according to the quality of machines they have and various offers that they are providing to their customers.

Ganesh Diagnostic and Imaging centre (GDIC), Rohini also known as GDIC or Ganesh lab is currently offering 50% discounts on various blood tests including quadruple marker test.

Our centers are NABH accredited and equipped with modern, highly expensive machines with latest cutting-edge technologies and highly skilled Radiologists and Pathologists. We follow strict aseptic conditions to prevent transmission of infections.

Charges of various tests used for the screening, evaluation and diagnosis of chromosomal abnormalities or structural defects in baby at Ganesh lab are as following: 

1.Screening Tests:

Quadruple marker test (AFP, hCG, Unconjugated estriol & Inhibin A) 

Rs 4250 - Rs 2125 Book Now

Triple marker test (AFP, hCG, Unconjugated estriol)

Rs 3000 - Rs 1500 Book Now

Double marker test (hCG, PAPP-A)

Rs 2850 - Rs 1425 Book Now

2.Diagnostic tests:

Amniocentesis 

Rs 13650 Rs 6825 Book Now

CVS (Chorionic villus sampling)

Rs 14300 - Rs 7150 Book Now

Cordocentesis or PUBS (Percutaneous Umbilical blood Sampling)

Rs 4140 - Rs 2075 Book Now

Hurry! Grab the best deals now!

For more details visit your nearest Ganesh Diagnostic and Imaging center (GDIC) today or call us now!

  • To avail free online consultation with Pathologist. Click here!
  • To avail free online consultation with Radiologist. Click here!
  • To know details about Obstetric ultrasound or ultrasound in pregnancy. Click here!
  • To know more about our services. Click here!

Best diagnostic centre for quadruple marker test in Delhi?

Ganesh Diagnostic and Imaging center (GDIC) is considered as the best diagnostic lab for Quadruple Marker test in Rohini, North-East Delhi. We have many branches in different locations of Delhi including Hari Nagar, Yamuna Vihar, Nangloi, Derawal Nagar and Mangol puri. 

Ganesh lab (GDIC) is now considered one of the most popular diagnostic labs in Delhi as: 

  • We provide high standard quality services to our patients. 
  • Experience of 23+ years of services.
  • Our labs are NABH certified.
  • Facility of latest cutting-edge technologies.
  • Well-trained technicians.
  • Highly Skilled Radiologists and Pathologists
  • Genuine reporting and Patient satisfaction are our top priority. 
  • We offer seamless integration between diagnosis and treatment planning. 
  • Affordable Diagnostic lab with up to 50% discount on many tests. Currently, we are offering flat 50% discount on various types of pregnancy ultrasounds and blood tests.
  • We are open 24X7 and 365 days.
  • You can also avail free Consultation with our Pathologist regarding any blood test or imaging scans.
  • We also offer facilities of online reporting, free home sample collection and free Ambulance services in Delhi, NCR.
  • We are empanelled with various departments and organizations. So, you can get the services at panel rate too.
  • Lakhs of satisfied customers.

Our empanellment with different departments and organisations:

  • DAK
  • CGHS NHA
  • ECHS
  • NDMC
  • DELHI JAL BOARD
  • RAILWAYS
  • NDMC
  • DGEHS
  • BSES YAMUNA / RAJDHANI POWER LTD
  • TATA POWER LTD
  • BABA SAHEB AMBEDKAR HOSPITAL
  • BJRM HOSPITAL
  • BHAGWAN MAHAVIR GOVERNMENT HOSPITAL

To know details about our empanellment with different organisations. CLICK HERE

For more details visit your nearest Ganesh Diagnostic and Imaging Center (GDIC) today or call us now!

Frequently Asked Questions Related Quadruple Marker Test (Faq’s)

Which sample is required for quadruple marker test?

Blood (Serum) sample is required for quadruple marker test.

How long does it take for quadruple marker test report? 

Quadruple marker test or Quad screening test report is usually available within 2-3 days of sample collection. 

What are the side effects of quadruple marker test to the baby?

Quad screen test has no risks or side effects to the baby as only maternal blood sample is taken.

What are the risks/side effects of quadruple marker test to the mother?

Quadruple marker test is a safe procedure with usually no side effects. However, some individuals may experience few side effects as mentioned below:

  • Pain at injection site.
  • Hematoma.
  • Multiple punctures to locate vein in those where veins are not easily accessible. 
  • Bleeding at puncture site, especially patients having bleeding or clotting disorders or those on anticoagulant therapy.
  • Infection at puncture site.
  • Thrombophlebitis.

Normal Quadruple marker test report analysis?

Normal range of quadruple markers may vary slightly from lab to lab as different labs follow different references. Usually, the normal range for quadruple markers can be summarized as following:

Parameters

Normal range

MSAFP

1.38-187 IU/ml

Beta-hCG

1.06-315 ng/ml

Unconjugated estriol (E3)

0.25-28.5 nmol/l

Inhibin-A

98-247 pg/ml

Description of terms used:

  • IU/ml: International Units Per Milliliter. 
  • ng/ml: Nanogram Per Milliliter.
  • nmol/l: Nanomoles Per Liter.
  • pg/ml: Picogram Per Milliliter.

How to interpret an abnormal quadruple marker test report?

A quadruple marker test is used to measure the levels of AFP, Beta-hCG, Unconjugated Estriol and Inhibin-A in maternal serum. It is a screening test and an abnormal result indicates higher risk of chromosomal anomalies or structural defects in baby. Results of quad screen can be understood as:

MSAFP

level

Beta-hCG level

Unconjugated estriol (E3) level

Inhibin A

level

Interpretation of Result

 

High risk of:

Low 

High

Low 

High

Down syndrome

Low 

Low 

Low 

Low or Normal

Edward syndrome

High

Normal 

Normal 

Normal

Abdominal wall defect or Neural tube defect

Description of terms used:

MSAFP: Maternal Serum Alpha-Fetoprotein

Beta-hCG: Human Chorionic Gonadotropin.

High levels of MSAFP are seen in which conditions?

An elevated or high level of MSAFP can be detected in the following conditions:

  • Multifetal pregnancy
  • Miscalculated or underestimated gestational age of baby
  • Endodermal sinus tumour
  • Severe oligohydramnios
  • Omphalocele
  • Gastroschisis
  • Renal abnormalities
  • Spina bifida 
  • Anencephaly
  • Encephalocele.

Low levels of MSAFP are seen in which conditions?

A reduced or low level of MSAFP can be detected in the following conditions:

  • Gestational trophoblastic diseases
  • Overestimated gestational age of baby
  • Spontaneous abortion
  • Obese mother
  • Down syndrome
  • Edward’s syndrome.

High levels of beta-hCG are seen in which conditions?

An elevated or high level of beta-hCG can be detected in the following conditions:

  • Multiple pregnancy
  • Molar pregnancy
  • Choriocarcinoma
  • Gestational trophoblastic neoplasia
  • Rh isoimmunization
  • Trisomy 21.

Low levels of beta-hCG are seen in which conditions?

A reduced or low level of beta-hCG can be detected in the following conditions:

  • Missed abortion
  • Ectopic pregnancy
  • Impending abortion
  • Trisomy 18.

High levels of unconjugated estriol are seen in which conditions?

A suddenly elevated or high level of unconjugated estriol can be detected in Premature labor.

Low levels of estriol are seen in which conditions?

A reduced or low level of unconjugated estriol can be detected in the following conditions:

  • Down syndrome
  • Edward syndrome
  • Non-pregnant female.

High levels of Inhibin-A are seen in which conditions?

An elevated or high level of Inhibin-A can be detected in the following conditions:

  • Down syndrome
  • Ovarian cancer.

Low levels of Inhibin-A are seen in which conditions?

A reduced or low level of Inhibin-A can be detected in the following conditions:

  • Edward syndrome
  • Premature ovarian failure
  • Post-menopause.

Can quadruple marker test confirm chromosomal defects in the baby?

Quadruple marker test or quad marker test is a screening test and not a confirmatory test. An abnormal quadruple marker test result implies:

  • A high suspicion/risk of chromosomal defects in baby. 
  • Need for additional confirmatory tests. 

What are the other tests available for screening chromosomal defects?

Some markers and imaging tests can be used for screening of chromosomal anomalies or structural defects in baby during pregnancy including:

  • Double marker test: It measures beta-hCG and PAPP-A (Pregnancy Associated Plasma Protein- A) in the maternal serum. It is usually done in 1st trimester of pregnancy.
  • Triple marker test: It measures AFP, beta-hCG and unconjugated estrogen (estriol or E3) in the maternal serum. It is usually done in 2nd trimester of pregnancy.
  • Pre-natal ultrasound: Some ultrasound scans can be used for screening chromosomal anomalies and structural defects in the baby such as:
    1. NT NB scan (Nuchal Translucency Nasal Bone scan): It is commonly performed in conjunction with dual marker test in the 1st trimester of pregnancy.
    2. Anomaly scan or TIFFA scan or Level 2 ultrasound: It is performed in the 2nd trimester of pregnancy.

How chromosomal or structural defects are diagnosed during pregnancy?

Chromosomal abnormalities or structural defects can be diagnosed in pregnancy with the help of the following tests:

  1. CVS (Chorionic villus sampling): Performed in 10-13 weeks of gestation using chorionic villi (trophoblastic cells).
  2. Amniocentesis: Performed in 16-20 weeks of gestation using amniotic fluid.
  3. Cordocentesis or PUBS (Percutaneous Umbilical blood Sampling).