You are now expecting. At this time, the doctor will ask you to do various tests to see if everything is going well for you and the baby in your womb, right? Today we are talking about a special blood test that is done in the second trimester of pregnancy. This is called the 'Quad Screen' or 'Quad Marker Screen'.
Simply put, what is Quad Screen?
This is a very simple blood test. It is done between 15 and 20 weeks of your pregnancy. This test can give your doctor some idea of whether your unborn baby is at risk of developing genetic conditions such as Down syndrome.
Why is this called "Quad"?
"Quad" means four in English. So this test is called this because it measures the levels of four specific things in your blood. Those four things are:
- AFP (Alpha-fetoprotein)
- HCG (Human chorionic gonadotropin)
- Estriol (a type of estrogen)
- Inhibin-A
What are these tests looking for?
The Quad Screen mainly assesses whether the baby is at risk for several genetic conditions. Some of the main conditions are:
- Trisomy 21: The condition we all know as Down syndrome.
- Trisomy 18: A condition called Edwards syndrome.
- Neural tube defects (NTDs): Problems with the development of a baby's brain and spinal cord.
But here's something you should definitely understand . This is just a 'screening' test. That means it's only a risk assessment. This test doesn't 100% say that the baby definitely has a certain condition. It just indicates that there is some risk, so further testing may be needed.
Is it mandatory to take this test?
No. This is not a mandatory test. You can do it only if you want. However, doctors who take care of pregnant mothers usually recommend that it is good to do this test. Because it can give you some idea about the baby's health in advance.
This is a very simple procedure. All you have to do is take a small blood sample from your arm. It takes about 5-10 minutes. It won't harm you or your baby. So there's no need to worry.
4 things to look for in blood and what they mean
Let's now look at what the four levels of change mean. This may be a little complicated, but I'll explain it simply.
| The substance measured in blood | What is read from its level |
|---|---|
| Alpha-fetoprotein (AFP) | It is produced by the baby's liver. If the AFP level is very high , it can indicate a risk of conditions such as neural tube defects. However, sometimes the AFP level can be higher if you are a few weeks pregnant or if you are carrying twins. If the AFP level is low , it can indicate a risk of Down syndrome. |
| Estriol (uE) | This hormone is produced by both the baby and the placenta. Low levels may indicate an increased risk of Down syndrome. |
| Human chorionic gonadotropin (hCG) | This hormone is produced by the placenta. Higher than normal levels of hCG can be a sign of an increased risk of Down syndrome. |
| Inhibin-A | This protein is produced by your ovaries and placenta. If its levels are higher than expected, it may increase the risk of having a baby with Down syndrome. |
I repeat, these are just risk factors. Just because one of these levels is different doesn't mean the baby will have a problem. Your doctor will compare these results with other factors, like your age, to assess the risk.
How do you get the results?
You will usually receive the results of this test within four to five days. This can vary depending on the lab and your doctor.
What if the result is 'Normal'?
If the result is 'Normal' or 'Negative', it means that your baby has a low risk of having the genetic condition mentioned above. In such cases, the doctor will often not recommend further genetic testing. However, even if it is 'low risk', it does not mean that there is 100% no problem. But it does mean that the risk is very low.
What if the result is 'Abnormal'?
Don't worry. An 'Abnormal' or 'Positive' result does not mean that the baby has a disease. It just means that the risk is high and that further testing is needed .
At this point, your doctor will talk to you and explain what to do next. They may also suggest some additional tests.
- Detailed Ultrasound Scan: This allows you to see the baby's body structures very clearly.
- Amniocentesis: This involves taking a small sample of the amniotic fluid surrounding the baby and examining the baby's cells to determine genetic conditions. There is a small risk with this test, so it is important to discuss it with your doctor before making a decision.
What is the difference between NIPT and Quad Screen?
You may have also heard of a test called NIPT (Noninvasive Prenatal Testing). It is also a screening test that looks at risk.
- The NIPT test can be done as early as 10 weeks into pregnancy. It analyzes the fetal DNA in your blood to assess risk.
- The Quad Screen is done in the second trimester . It doesn't look at the baby's DNA, but at the levels of hormones and proteins in your blood.
Both of these tests are 'screening' tests that measure risk, not 'diagnostic' tests. Talk to your doctor to decide which test is best for you.
Expecting a baby is a wonderful time, but it can also bring up a lot of emotions. It's normal to feel a little scared and anxious when you learn about these tests. But these tests are not meant to scare you. They are meant to help you be aware of your baby's health in advance and, if necessary, prepare for it. So if you have any questions, don't hold them in your mind and ask your doctor.
Take-Home Message
- Quad Screen is a non-mandatory blood test performed during the second trimester of pregnancy.
- This assesses whether the baby is at risk of developing genetic conditions such as Down syndrome.
- This is a 'screening' test that measures risk, not a 'diagnostic' test that definitively identifies a disease.
- If the result is 'Abnormal', don't panic, it only means that further testing is needed.
- Before undergoing any test and after receiving the results, discuss all concerns and doubts with your doctor.
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