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Quadruple Marker with Graph - 2nd Trimester

Also referred as

Quadruple marker test

Quad marker screening

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A Quadruple Marker with Graph - 2nd Trimester test is the most common blood screening test done between the 14th and 22nd weeks (ideal 15-20 weeks, i.e., 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.

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Understanding Quadruple Marker with Graph - 2nd Trimester

A Quadruple Marker with Graph - 2nd Trimester test is a prenatal screening test tailored to provide expectant parents with insights into the developing baby's health. 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 Quadruple Marker with Graph - 2nd Trimester 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), Estriol unconjugated (uE3), and Inhibin A. When assessed collectively, the levels of these markers help estimate 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 effectively addressing potential health problems. In addition to the traditional Quad marker analysis, the inclusion of a graphical representation enhances the interpretability of results.

A Quadruple Marker with Graph - 2nd Trimester test is a screening test only; any abnormal result does not mean 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 recommendation of a Quadruple Marker with Graph - 2nd Trimester 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 Quadruple Marker with Graph - 2nd Trimester test. However, a woman needs 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 the baby is affected; further tests must be performed before a confirmed diagnosis can be made. Talk to your doctor about your specific test results.

What does Quadruple Marker with Graph - 2nd Trimester measure?

Contains 4 tests

A Quadruple Marker with Graph - 2nd Trimester test measures the levels of four specific markers in a pregnant woman's blood. These markers are -Alpha-Fetoprotein (AFP), Human Chorionic Gonadotropin (hCG), Estriol Unconjugated , and Inhibin-A.

The analysis of these four markers and other factors like maternal age and gestational age helps assess the risk of certain conditions in the developing baby. The graph in a Quadruple Marker with Graph - 2nd Trimester provides a visual representation of the levels of these markers during pregnancy.

It is noteworthy that a Quadruple Marker with Graph - 2nd Trimester 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.

Inhibin A

The Inhibin A test measures the level of inhibin A in the blood. It is a hormone primarily produced by the ovaries in women. It plays a key role in regulating menstrual cycle and ovarian function by inhibiting the production of follicle-stimulating hormone (FSH). During pregnancy, elevated levels of Inhibin A may point towards a risk of certain chromosomal abnormalities like Down’s syndrome etc., in the fetus.

The Inhibin A test is particularly useful in assessing ovarian function, fertility assessment, prenatal screening and diagnosing certain ovarian cancers.

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HCG Beta Total Quantitative, Maternal

The HCG Beta Total Quantitative, Maternal test measures the levels of human chorionic gonadotropin (hCG) hormone in the blood. hCG is released in the blood during pregnancy and can be detected as early as 10 to 12 days after conception. The levels of this hormone gradually rise every 2 to 3 days (or 48 to 72 hours) and peak around 8 to 11 weeks after conception. After reaching the peak, the hCG levels decrease and remain steady for the rest of the pregnancy.

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Alpha Feto Protein, Maternal

An Alpha Feto Protein, Maternal test measures the amount of Alpha Fetoprotein in expectant mothers usually during the second trimester (14th and 22nd weeks). AFP is a protein produced by the fetus, primarily by the fetal liver and yolk sac, and it passes into the mother's blood. The test is typically performed to screen for certain fetal abnormalities, particularly neural tube defects (NTDs) such as spina bifida and anencephaly, as well as chromosomal abnormalities like Down syndrome (trisomy 21), Edwards syndrome (Trisomy 18), etc.

Detecting these abnormalities early in pregnancy allows for appropriate medical management and intervention.

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Estriol Unconjugated

The Estriol Unconjugated test is used to assess the level of unconjugated estriol (uE3) in the blood, a specific type of estrogen produced during the pregnancy phase. This hormone is mainly synthesized in the placenta and the fetus, with the fetus being responsible for a substantial amount of uE3 production as it grows.

Monitoring the uE3 levels in the maternal serum is useful in evaluating the condition of the fetus. Abnormal unconjugated estriol levels may indicate pregnancy-related complications or concerns, including chromosomal abnormalities, fetal distress, or placental problems. The Estriol Unconjugated is particularly crucial in the second trimester to assess for some conditions, such as Down syndrome, Edward syndrome, or other chromosomal abnormalities, fetal growth and development. Hence the estriol unconjugated test is a significant part of prenatal care as it reveals information that may be valuable for the diagnosis and management of the mother and the baby.

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FAQs related to Quadruple Marker with Graph - 2nd Trimester

What is a Quadruple Marker with Graph - 2nd Trimester test, and why is it important?

A Quadruple Marker with Graph - 2nd Trimester 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.

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.

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.

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.

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).

Is a Quadruple Marker with Graph - 2nd Trimester test only advised for women of age 35 years or more?

No, this test is not specific to women aged 35 or older. It is recommended for all pregnant women, serving as an important test for detecting fetal abnormalities before birth. However, this test is highly recommended in women with risk factors like age of 35 or older, family history of birth defects, having a previous child with a birth defect, known type 1 diabetic woman, viral infection/ radiation exposure/ harmful drugs during pregnancy.

What does a normal Quadruple Screening test mean?

A normal quad marker test result (or a negative result) means the fetus is not at higher risk for a congenital disorder. It just means the risk is low but does not rule out other chromosomal defects like single-gene disorder or other complications.

What does an abnormal Quadruple Screening test mean?

The quad screen only checks your risk. It doesn’t tell if the developing baby has a genetic disorder. If your quad screen shows an increased risk for a congenital disorder, your doctor will suggest other tests like additional ultrasound or amniocentesis, which help determine if the fetus has a genetic disorder.

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.

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.

What are Neural tube defects?

Neural tube defects (NTDs), including spina bifida and anencephaly, are birth defects of the brain, spinal cord, and spine that occur due to abnormal neural tube development in the fetus. The diagnosis is made on maternal USG during pregnancy or by estimation of maternal serum alpha-fetoprotein (MSAFP) levels early in the second trimester (15–18 weeks of gestation).

Content created by

Dr. Swati Gupta (Anand)

MD Lab Medicine, MBBS

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Last Updated

14th Oct 2025