BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuQuadruple screen testQuad screen; Multiple marker screening; AFP plus; Triple screen test; AFP maternal; MSAFP; 4-marker screen; Down syndrome - quadruple; Trisomy 21 - quadruple; Turner syndrome - quadruple; Spina bifida - quadruple; Tetralogy - quadruple; Duodenal atresia - quadruple; Genetic counseling - quadruple; Alpha-fetoprotein quadruple; Human chorionic gonadotropin - quadruple; hCG - quadruple; Unconjugated estriol - quadruple; uE3 - quadruple; Pregnancy - quadruple; Birth defect - quadruple; Quadruple marker test; Quad test; Quadruple marker screenThe quadruple screen test is a blood test done during pregnancy to determine whether the baby is at risk for certain birth defects. How the Test is Performed This test is most often done between the 15th and 22nd weeks of the pregnancy. It is most accurate between the 16th and 18th weeks.A blood sample is taken and sent to the lab for testing. Blood sampleVenipuncture is the collection of blood from a vein. It is most often done for laboratory testing.ImageRead Article Now Book Mark Article The test measures levels of 4 pregnancy hormones:Alpha-fetoprotein (AFP), a protein produced by the baby Human chorionic gonadotropin (hCG), a hormone produced in the placenta Unconjugated estriol (uE3), a form of the hormone estrogen produced in the fetus and the placenta Inhibin A, a hormone released by the placenta If the test does not measure levels of inhibin A, it is called the triple screen test.To determine the chance of your baby having a birth defect, the test also factors in:Your age Your ethnic background Your weight Your baby's gestational age (measured in weeks from the day of your last period to the current date) Gestational ageGestation is the period of time between conception and birth. During this time, the baby grows and develops inside the mother's womb. Gestational ag...Read Article Now Book Mark Article How to Prepare for the Test No special steps are needed to prepare for the test. You can eat or drink normally before the test. How the Test will Feel You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn. Why the Test is Performed The test is done to find out if your baby might be at risk for certain birth defects, such as Down syndrome and birth defects of the spinal column and brain (called neural tube defects). This test is a screening test, so it does not diagnose problems.Certain women are at greater risk of having a baby with these defects, including:Women who are over 35 years old during pregnancy Women taking insulin to treat diabetes Women with a family history of birth defects Normal Results Normal levels of AFP, hCG, uE3, and inhibin A.Normal value ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results. What Abnormal Results Mean An abnormal test result does NOT mean that your baby definitely has a birth defect. Often, the results can be abnormal if your baby is older or younger than your provider had thought. If you have an abnormal result, you will have another ultrasound to check the age of the developing baby.More tests and counseling may be recommended if the ultrasound shows a problem. However, some people choose not to have any more tests done, for personal or religious reasons. Possible next steps include:Amniocentesis, which checks the AFP level in the amniotic fluid surrounding the baby. Genetic testing can be done on the amniotic fluid removed for the test. AmniocentesisAmniocentesis is a test that can be done during pregnancy to look for certain problems in the developing baby. These problems include:Birth defectsG...ImageRead Article Now Book Mark Article Tests to detect or rule out certain birth defects (such as Down syndrome). Genetic counseling. Ultrasound to check the baby's brain, spinal cord, kidneys, and heart. Prenatal cell-free DNA screening, which uses cell-free DNA from the placenta and the fetus in the mother's bloodstream. A normal result might help avoid needing amniocentesis.During pregnancy, increased levels of AFP may be due to a problem with the developing baby, including:Absence of part of the brain and skull (anencephaly) Defect in the baby's intestines or other nearby organs (such as duodenal atresia) Duodenal atresiaDuodenal atresia is a condition in which the first part of the small bowel (the duodenum) has not developed properly. It is not open and cannot allo...ImageRead Article Now Book Mark Article Death of the baby inside the womb (usually results in a miscarriage) MiscarriageA miscarriage is the spontaneous loss of a fetus before the 20th week of pregnancy. Pregnancy losses after the 20th week are called stillbirths. Mi...ImageRead Article Now Book Mark Article Spina bifida (spinal defect) Spina bifidaMyelomeningocele is a birth defect in which the backbone and spinal canal do not close fully before birth. The condition is a type of neural tube de...ImageRead Article Now Book Mark Article Tetralogy of Fallot (heart defect) Tetralogy of FallotTetralogy of Fallot is a type of congenital heart defect. Congenital means that it is present at birth.ImageRead Article Now Book Mark Article Turner syndrome (genetic defect) Turner syndromeTurner syndrome is a rare genetic condition in which a female does not have the usual pair of X chromosomes.ImageRead Article Now Book Mark Article High AFP can also mean that you are carrying more than 1 baby.Low levels of AFP and estriol and high levels of hCG and inhibin A may be due to a problem such as:Down syndrome (trisomy 21) Edwards syndrome (trisomy 18) Edwards syndromeTrisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Rarely, the extra...ImageRead Article Now Book Mark Article Considerations The quadruple screen can have false-negative and false-positive results (although it is slightly more accurate than the triple screen). More tests are needed to confirm an abnormal result.If the test is abnormal, you may need to talk to a genetic counselor.Open ReferencesReferencesACOG Practice Bulletin No. 162: Prenatal diagnostic testing for genetic disorders. Obstet Gynecol. 2016;127(5):e108-e122. PMID: 26938573 pubmed.ncbi.nlm.nih.gov/26938573/.Driscoll DA, Simpson JL. Genetic screening and prenatal genetic diagnosis. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 10.Wapner RJ, Dugoff L. Prenatal diagnosis of congenital disorders. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 32.Williams DE, Pridjian G. Obstetrics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 20.AllVideoImagesTogQuadruple screen - illustration A blood test can be performed between the 15th and 22nd weeks of the pregnancy to determine whether the baby is at risk for certain birth defects. Blood is drawn from a vein and the sample is sent to a laboratory for testing. If the test is abnormal other tests can be performed to rule out birth defects.Quadruple screenillustrationQuadruple screen - illustration A blood test can be performed between the 15th and 22nd weeks of the pregnancy to determine whether the baby is at risk for certain birth defects. Blood is drawn from a vein and the sample is sent to a laboratory for testing. If the test is abnormal other tests can be performed to rule out birth defects.Quadruple screenillustrationSelf Care Prenatal care in your first trimester Tests for Quadruple screen test Quadruple screen testRelated Information Review Date: 1/10/2022 Reviewed By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. 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