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Double Marker Test- First Trimester

Also referred as
Dual Marker Test
Maternal Serum Screening (MSS) - First Trimester
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The Double Marker Test- First Trimester also known as a dual marker test, assesses specific biomarkers in a pregnant woman’s blood. It is done during the first trimester of pregnancy, usually between 11-13 weeks. This test provides information about the risk of certain birth defects such as Down syndrome (Trisomy 21), Edward syndrome (Trisomy 18), and Patau syndrome (Trisomy 13) in the developing fetus.

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Understanding Double Marker Test- First Trimester

Prenatal care is necessary to ensure a healthy pregnancy and successful childbirth. Early prenatal screenings identify potential health concerns and guide medical interventions when necessary. The Double Marker Test- First Trimester is essential for early prenatal assessment. It offers invaluable insights into the developing fetus's chromosomal health. The test primarily measures two important biomarkers in the mother’s blood—human chorionic gonadotropin (hCG) and pregnancy-associated plasma protein A (PAPP-A). Both the markers are produced by the fetus and the placenta.

The test also checks if the baby might be at risk for certain genetic problems, especially Down syndrome and Edwards syndrome. These conditions happen when there is an extra copy of chromosome 21 or 18, respectively. They can affect a baby's physical and intellectual development. However, a Double Marker Test-First Trimester is a screening test, not a diagnostic one. It does not determine whether the baby has abnormalities. Instead, it tells whether the unborn baby is at risk of developing certain abnormalities.

The test results are reported as a risk score or probability of the fetus having a chromosomal abnormality. Test results within the expected range suggest a lower risk of chromosomal abnormalities. On the contrary, high levels may indicate a higher risk of chromosomal abnormalities and prompt further testing. Furthermore, a positive screen result (high risk) does not confirm a genetic problem. It may suggest that further testing may be needed to check the baby's health more closely. On the other hand, a negative screen result (low risk) does not guarantee the absence of fetal defects.

In combined risk assessment, the NT scan (a type of ultrasound) is also used to check for conditions like Down syndrome and Patau syndrome. This, along with the mother’s details—such as age, weight, smoking, diabetes, or IVF pregnancy—is included in the overall risk calculation. However, this test does not check for neural tube defects.

No fasting is required for a Double Marker Test-First Trimester. Let the doctor know about any medical conditions, allergies, or medicines being taken, as some medicines may affect the test results and might need to be stopped before getting tested.

Talk to the doctor about the specific test results. The accuracy of the results is subjective to the information provided in the screening form. This information is mandatory for combined risk assessment.

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What does Double Marker Test- First Trimester measure?

The Double Marker Test- First Trimester measures two biomarkers in maternal blood associated with chromosomal abnormalities.

a) Free beta-hCG (human chorionic gonadotropin): a hormone made by the placenta shortly after a woman becomes pregnant.

b) PAPP-A (pregnancy-associated plasma protein-A): a protein made by the placenta during early pregnancy. It helps the placenta grow and function properly.

These, along with the USG marker and nuchal translucency (NT) measurement, are effective in Combined screening for Down syndrome and trisomy 13/18 in the fetus. This test only gives the risk for the presence of these chromosomal abnormalities in the developing fetus. A positive screen is not diagnostic but indicates that further evaluation should be considered.

hCG is synthesized by the placenta very early in pregnancy and can be detected in the blood 8-11 days after conception. Higher levels of hCG after 11 weeks of gestation may suggest a higher chance of the baby having Down syndrome. On the other hand, low levels indicate an increased risk for trisomy 18.

PAPP-A is a protein produced by the placenta that is needed for the implantation and maintenance of a healthy placenta (afterbirth). Low levels of PAPP-A before the 14th week of pregnancy suggest an increased risk of fetal chromosomal abnormalities.

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Double Marker Test- First Trimester test price for other cities

Price inBangaloreRs. 2559
Price inNew DelhiRs. 2160
Price inNoidaRs. 2280
Price inGhaziabadRs. 2280
Price inPuneRs. 2339
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FAQs related to Double Marker Test- First Trimester

The Double Marker Test- First Trimester is a prenatal screening test for pregnant women. It helps assess the risk of chromosomal abnormalities in the developing fetus. It is performed to assess the risk of potential genetic conditions such as Down syndrome and Edwards syndrome.
An NT scan is an ultrasound, and a dual marker is a blood test. Both of the tests are done during the first trimester to screen for the possible risk of chromosomal abnormalities in the unborn child.
A dual marker test is typically conducted during the first trimester of pregnancy, i.e., between weeks 9 and 13. But it is advised to get tested between 11 - 13 weeks along with NT values from the USG report as it gives Combined risk which is better.
No, the Double Marker Test- First Trimester is generally safe with minimal risks. However, you may feel slight discomfort during blood sample collection, but the chances of serious complications are extremely rare.
No fasting is required for this test. You can schedule it at your convenience without avoiding food or water beforehand.
The first-trimester screening combines two blood tests and a special ultrasound (with NT measurement in mm, CRL value, and nasal bone (NB). In combined risk assessment, the risk score from blood tests is interpreted in conjunction with the nuchal translucency (NT) measurement and maternal demographic information like age, weight, smoking, diabetic status, IVF pregnancy, etc., to assess the overall risk profile. This increases both the sensitivity and specificity of the screening results.
A negative screen means it is unlikely the fetus has Down syndrome, trisomy 18. However, a negative screen does not guarantee the birth of a healthy baby. The screening test only screens for Down syndrome and trisomy 18; it is not a diagnostic test. The maternal demographic information also is used to help calculate the baby’s risk of having Down syndrome or Trisomy 18. Please check the demographic information to ensure the accuracy of the calculated results.
The dual marker test screens for: a) Down syndrome (Trisomy 21); b) Patau syndrome (Trisomy 13); c) Edwards syndrome (Trisomy 18).
The test involves a simple blood draw from the pregnant woman and poses no risk to the developing fetus. Furthermore, the test is noninvasive and carries no risks to the pregnancy. It is considered a safe screening test.
A dual marker is a screening test and not a diagnostic test. It screens for the risk of chromosomal abnormalities and doesn’t identify the specific abnormality. Confirmatory tests are required for a definitive diagnosis.
Down syndrome, also known as Trisomy 21, is a genetic disorder caused by the presence of an extra copy of chromosome 21 in a person's DNA (genetic material). It can cause various physical and intellectual challenges.
Edwards’ syndrome, also known as Trisomy 18, is a rare genetic disorder caused by the presence of an extra copy of chromosome 18. It typically results in severe intellectual and developmental disabilities.
If you miss the time for the Dual Marker Test, your doctor might suggest another test, like the Quad Marker Test. Quad Marker test is usually done between the 15th and 21st week of pregnancy.
No, it is an optional test. However, doctors often recommend it for early screening, especially for women over 35 or with a family history of genetic conditions.
Tata 1mg ensures accurate lab test results through certified laboratories. Tata 1mg uses advanced technology and adheres to stringent quality control measures. This commitment to high standards guarantees reliable results.
References
  1. Wald N, Densem J, Stone R, Cheng R. The use of free beta-hCG in antenatal screening for Down's syndrome. Br J Obstet Gynaecol. 1993 Jun;100(6):550-7. [Accessed 22 Sept. 2023]. Available from:
  2. Ong CY, Liao AW, Spencer K, Munim S, Nicolaides KH. First trimester maternal serum free beta human chorionic gonadotrophin and pregnancy-associated plasma protein A as predictors of pregnancy complications. BJOG. 2000 Oct;107(10):1265-70. [Accessed 22 Sept. 2023]. Available from:
  3. Mirsafaie M, Moghaddam-Banaem L, Kheirollahi M. The Relationship between Screening Markers in the First Trimester of Pregnancy and Chromosome Aberrations. Int J Prev Med. 2022 Apr 27;13:81. [Accessed 22 Sept. 2023]. Available from:
  4. Shah KH, Anjum A, Nair P, Bhat P, Bhat RG, Bhat S. Pregnancy-associated plasma protein A: An indicator of adverse obstetric outcomes in a South India population. Turk J Obstet Gynecol. 2020 Mar;17(1):40-45. [Accessed 22 Sept. 2023]. Available from:
  5. Shiefa S, Amargandhi M, Bhupendra J, Moulali S, Kristine T. First Trimester Maternal Serum Screening Using Biochemical Markers PAPP-A and Free β-hCG for Down Syndrome, Patau Syndrome and Edward Syndrome. Indian J Clin Biochem. 2013 Jan;28(1):3-12. [Accessed 22 Sept. 2023]. Available from:
  6. Commit to Healthy Choices to Help Prevent Birth Defects [Internet]. CDC; 28 June 2023 [Accessed 22 Sept. 2023]. Available from:
  7. Infections in pregnancy that may affect your baby [Internet]. CDC; 10 March 2021 [Accessed 22 Sept. 2023]. Available from:
  8. 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 22 Sept. 2023]. Available from:
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