What is the Triple Marker Test in Pregnancy?

what is triple marker test in pregnancy and why we should consider

Becoming parents is never easy, and pregnancy brings several responsibilities and expectations. A Triple Marker Screen Test allows you to screen for potential genetic abnormalities in an unborn baby, offering peace of mind or early detection.

If detected early on, it can be a game-changer. Knowing about the test itself is also comforting, as it will assure you that you are taking great care of your baby.

Are you a parent-to-be and curious to know more about this important test? In this article, we will give you a clearer idea of the purpose and benefits of the Triple Marker Test.

Team Digit

What is the Triple Marker Test?
Purpose of Triple Marker Test
Is the Triple Marker Test Mandatory?
Triple Marker Test Benefits
Things to Do Before the Test
Triple Marker Test Procedure
Things to Do After Test
How to Read Test Report?
How Accurate is this Test?
Cost of a Triple Marker Test?
Double Marker vs Triple Marker
Frequently Asked Questions

What is a Triple Marker Test in Pregnancy?

A triple marker test is used in the healthcare sector to analyze if your unborn baby is prone to having certain genetic disorders, such as Down syndrome, spina bifida, or anencephaly. Doctors use this test to mainly indicate any abnormalities in an unborn baby without diagnosing the exact problem.

What is the Purpose of Conducting a Triple Marker Screen Test?

The purpose of a triple marker test in pregnancy is to screen the development of a baby inside the womb and check for any possibilities of neural tube defects. The test uses the following three substances to generate the results.

1. Alpha-fetoprotein (AFP)

It is a protein that the foetus produces. If high levels of this particular protein are present in your blood, it might indicate potential congenital disabilities, including neural tube defects.

2. Human Chorionic Gonadotropin (HCG)

This is a hormone that the placenta produces. Low levels of this hormone in your blood indicate potential pregnancy issues, including possibilities of miscarriage or ectopic pregnancy. High levels indicate chances of molar pregnancy or multiple pregnancies.

3. Estriol

It is an oestrogen coming from both the foetus and the placenta. Low levels of this in the mother’s blood might indicate possible defects in the unborn baby, such as Down syndrome.

Is Triple Marker Test Mandatory in Pregnancy?

The Triple Marker Test is an optional test in pregnancy that is recommended by healthcare providers, most especially for women with increased chances of having babies with genetic defects. These are mothers whose ages exceed thirty-five years, those who have relatives with genetic disorders, and those whose earlier tests were abnormal.

Even though the test is optional, it provides useful facts that enable a woman to make informed decisions about pregnancy. Finally, whether or not to take this examination depends on parents after considering their preferences and discussing possible advantages and disadvantages of this screening with a doctor.

Benefits of the Triple Marker Test in Pregnancy

Some of the standard benefits of a triple marker screen test are as follows.

It helps to detect congenital disabilities in the early stages.
You can identify the possibilities of severe health hazards for your unborn baby.
The test also detects if a woman is expecting two or more babies.
It can diagnose possibilities of other pregnancy complications, making it easier for the doctor to treat.
This examination can provide valuable details when needed, allowing people to make choices about further checkups.
Expecting moms and dads feel at ease knowing that they are doing everything possible for their child’s well-being and development.
For instance, this information allows for proper planning and individual attention throughout gestation.

How to Prepare for a Triple Marker Screen Test?

A triple marker test requires no preparation, making it easy and convenient. You don't need to change your daily routine before the test. Also, there are no drinking or eating requirements before taking the test; you can eat and drink as you normally would. This means you can go about your routine without worrying about fasting or adjusting your meals.

Procedure for a Triple Marker Test in Pregnancy

Step 1: Doctors take your blood sample to measure the levels of AFP, HCG, and Estriol.
Step 2: First, the doctors or technicians draw blood from your vein by inserting a needle.
Step 3: They collect the blood in a small test tube.
Step 4: The collected blood is sent to the lab for analysis.
Step 5: Women usually take this test around 15-20 weeks of pregnancy.

Usually, this test will be beneficial for mothers meeting the following conditions.

Over the age of 35 years or more
Having a family history of genetic defects
Suffering from diabetes and using insulin
Have been through high levels of radiation therapy before
Suffering from viral infection during pregnancy

Things to Do After Triple Marker Screen Test

After taking your triple marker screen test, you should keep a few things in mind. Below are a few points to consider after undergoing the Triple Marker Screen Test:

Things to Do	Description
Results Review	Consult your doctor on the implications of the test result. Discuss what the findings mean for you and your baby, including the need for further testing.
Other Tests	If these results show an increased chance for abnormalities, your physician may propose other diagnostic tests or a detailed ultrasound.
Consultation	Seek genetic counselling to understand the meaning behind these findings and the potential consequences thereof.
Decision-Making	You may need to carefully weigh pregnancy-related choices based on the results and extra tests.
Aftercare	Plan subsequent appointments to monitor your pregnancy and address any concerns that surface during the process.

It is crucial to keep informed and seek advice from a medical professional during this stage.

How to Read a Triple Marker Screen Test Report?

how to read and analyze a triple marker test in pregnancy

The reading of this test is quite simple. If a triple marker test results positive, it means there are higher-than-average chances of your baby having congenital disabilities. On the other hand, if the result is negative, it means that your baby has no defects and is completely healthy.

Normal Outcome

The normal values for the triple marker test are described in the following table.

Disorder	Cut-off	Detection Rate	False Positive Rate
Trisomy 21 (Down)	0.215277778	65%	5%
Trisomy 18	0.111111111	60%	0.30%
Neural tube defects	>= 2.5 MoM	70% - 75%	2% - 4%

Positive Outcome

A triple marker test report is a screen test that reveals the likelihood of a genetic disorder, not a foetus's exact defects. Its accuracy depends on how often the test can find a congenital disability. In past cases, these tests have successfully spotted 80 out of 100 foetuses with anencephaly and 69 out of 100 foetuses with Down syndrome.

The positive values for the triple marker test are described in the following table.

Disorder	Cut-off	Detection Rate	False Positive Rate
Trisomy 21 (Down)	5:10	65%	5%
Trisomy 18	2:40	60%	0.30%
Neural tube defects	≥ 2.5 MoM	70% - 75%	2% - 4%

Negative Outcome

Having said that, there are still chances of false-positive test results. For instance, this test might show a problem in a healthy foetus. In addition, it leads to severe anxiety and tension in the mother, leading to pregnancy complications for no reason.

The negative values for the triple marker test are described in the following table.

Disorder	Cut-off	Detection Rate	False Positive Rate
Trisomy 21 (Down)	5:10	0%	100%
Trisomy 18	2:40	0%	100%
Neural tube defects	≥ 2.5 MoM	0%	100%

How Accurate is the Triple Marker Test?

While useful for screening, the triple marker test cannot be considered a definite diagnostic test. The detection rate of certain chromosomal abnormalities, such as Down syndrome, is about 70-80%.

Nevertheless, false negatives and positives are possible in this case, which means no problem can be found by the test even when there exists, or it may easily miss an abnormality. Additional diagnostics, such as amniocentesis, may be advised to obtain more precise findings, particularly if the Triple Marker Test indicates higher risk levels.

What is the Cost of a Triple Marker Test in Pregnancy?

Typically, the cost of a triple marker test during pregnancy ranges between ₹1,500 and ₹3,500 in India. It varies depending on location, healthcare institution, and particular laboratory conducting this procedure. For accurate prices, one can contact local hospitals or diagnostic centres.

Difference Between Double Marker and Triple Marker

The two popular tests are often prescribed to pregnant women. Learning the difference between Double Marker and Triple Marker tests is a must.

Aspect	Double Marker Test	Triple Marker Test
Components Measured	Free Beta hCG, PAPP-A	Alpha-fetoprotein (AFP), hCG, Estriol
Purpose	Screens for chromosomal abnormalities like Down syndrome (Trisomy 21) and Trisomy 18	Screens for Down syndrome, Trisomy 18, and neural tube defects
Timing	1st trimester (10-14 weeks)	2nd trimester (15-20 weeks)
Scope	Limited to early detection of certain chromosomal abnormalities	Provides a broader screening for more conditions, including neural tube defects

When Should You See a Doctor?

If you receive negative indicators on your triple marker test, you must make some immediate decisions to move forward. Thus, this is probably the right time to see a doctor and take professional advice. While such a result can be concerning, there is still room for investigation and diagnosis.

If the results are positive, your doctor might ask you to go for an amniocentesis test. For this, they will extract an amniotic fluid sample from your uterus to detect the possibility of foetal infections. If this test shows high levels of AFP presence, they will ask for detailed ultrasonography to check the foetal skull and spine for neural tube defects.

Thus, it is evident that a triple marker test can be vital for parents to know about the health hazards of their unborn child. These tests can only detect the likelihood of such defects, but there are chances of inaccurate results. Therefore, it is essential to consult a doctor and arrange for further diagnosis instead of unnecessarily worrying about positive results.

FAQs about Triple Marker Test in Pregnancy

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What are the next steps if the triple marker screen test results show negative?

A negative result usually means that your baby is healthy and there are no apparent risks with your pregnancy. However, this is not a guaranteed result, and it is advisable to consult your doctor and keep track of the pregnancy.

What is the normal range of e3 in pregnancy?

In normal ranges, uE3 levels increase from about 4 nmol/L at 15 weeks to about 40 nmol/L at delivery. This range is usually considered normal.

What is the Triple Marker Test?

The Triple Marker Test is a prenatal blood test that measures three substances in a pregnant woman’s blood—Alpha-fetoprotein (AFP), hCG, and Estriol—to evaluate the probability of chromosomal abnormalities such as Down syndrome, Trisomy 18, and neural tube defects.

Is the Triple Marker Test necessary after the Double Marker Test?

Even after the double marker, the triple marker test may be recommended for further screening, especially if the initial results are equivocal or there is an increased risk of certain conditions.

How accurate is the Triple Marker Test?

The accuracy level of this test ranges between 70-80% for some abnormalities detected; however, it doesn’t make it absolute, and more diagnostic tests may be needed to confirm this.

What is a normal urine culture level?

A normal urine culture typically shows no growth or bacterial count below 10,000 colony-forming units per millilitre (CFU/mL), indicating the absence of a urinary tract infection.

What happens if the Triple Marker Test is positive?

If your triple marker is positive, it means that you have a higher chance of abnormalities; thus, further diagnostic testing, such as amniocentesis or detailed ultrasound, may be recommended to confirm this.

When is the best time to do the Triple Marker Test?

The best time to perform the Triple Marker Test is during the second trimester, typically between 15 and 20 weeks of pregnancy.

Which disease is diagnosed with the Triple Marker Test?

The Triple Marker Test helps in screening for chromosomal abnormalities like Down syndrome, Trisomy 18, and neural tube defects.

What is the normal range of the Triple Marker Test?

The normal range of the Triple Marker Test varies based on the individual markers and the gestational age, so a healthcare provider interprets it in the context of other factors. Typically, the results are presented as multiples of the median (MoM).

Is it safe to take the Triple Marker Test?

Yes, the Triple Marker Test is a safe, noninvasive blood test that poses no risk to the mother or baby.

What precautions should be taken before the Triple Marker Test?

No specific precautions are required before the Triple Marker Test, but it's important to inform your healthcare provider of any medications or conditions that may affect the results.

Is fasting required for the Triple Marker Test?

Fasting is not required for the Triple Marker Test; you can eat and drink normally before the test.

What happens during the Triple Marker Test?

During the Triple Marker Test, a blood sample is drawn from the mother, which is then analysed in a lab to measure the levels of AFP, hCG, and Estriol.

What is the most common cause of an abnormal Triple Screen Test?

The most common cause of an abnormal Triple Screen Test is a miscalculation of gestational age, followed by conditions like Down syndrome, Trisomy 18, and neural tube defects.

Why do doctors suggest a Triple Marker Test?

Doctors suggest a Triple Marker Test to assess the risk of certain genetic abnormalities in the foetus, especially if there are risk factors or if the parents want additional screening information.

How do I know if the Triple Marker is normal?

The results of the Triple Marker Test are interpreted by your healthcare provider, who will compare the levels of AFP, hCG, and Estriol to the expected range for your stage of pregnancy and provide you with the findings.