Triple Marker Test During Pregnancy: Why, When & How

Every parent hopes and prays they have a healthy child. However, when your little one is in the womb, it is a daunting thought to be unaware of her wellbeing. This is why doctors work hard to ensure that you have a clear idea of how healthy your baby is and how they can help ensure optimum health of your baby at all times. The same can be done using a series of tests and one of the most important amongst these is the multiple markers or the triple marker test.

What is Triple Marker Test?

The Triple Marker Test (also known as triple screen test) is a simple non-invasive blood test that is carried out between the 15th and 22nd week of pregnancy. It measures three hormones:

• AFP or alpha-fetoprotein which is a protein produced by the developing foetus.
• hCG or human chorionic gonadotropin which is a hormone produced by the placenta.
• uE3 or unconjugated estriol is the hormone oestrogen produced by both the foetus and the placenta.

The test is carried to find out if the developing foetus is at a risk of having certain birth defects. While the tests themselves are not specific indications of specific conditions or diseases, they can certainly identify the risk factor for the foetus.

Why is It Called a ‘Screening Test’?

It is imperative to understand what a screening test is in order to get more comfortable while getting one done. A screening test is not a diagnosing tool. It compares a number of parameters like age, ethnicity, results from blood tests, etc. before providing an indication of a risk factor for certain abnormalities to be present. A screening test is not conclusive in terms of pinpointing at a specific problem, however, it simply helps obtain a directive if further tests need to be performed to ascertain a particular condition or a problem.

Reasons to Have a Triple Test

The triple test can provide important information on your pregnancy to your doctor. Here a few ways it helps:

• Most neural tube defects can be detected early on in the pregnancy through this test.
• A Down syndrome triple test is indicative of Trisomy 21 (downs syndrome).
• Triple test is also indicative of Trisomy 18 (Edwards Syndrome) pregnancies.
• The trisomy test helps identify if you are having multiple pregnancies.
• The test also detects other abnormalities that could help your doctor proceed further with a diagnosis.

When Should You Get the Triple Test?

As discussed, the triple test in pregnancy should be done between week 15 and week 22. However, the most accurate result is obtained between week 16 and 18. The results of your test will be available within two to four days.

What Preparation Should You Do for Triple Marker Screen Test?

Fortunately, there is no food or drink restrictions needed for this test. The side effects are negligible as it is a non-intensive test carried out by drawing a blood sample. It has minimal risk for the mother as well as the baby.

How is the Test Done?

The triple test procedure is the same as the procedures involved in any other blood test:

• Step 1: The doctor or the technician will ask you to extend your arm and make a fist; this is to find your vein.
• Step 2: They will then place a strap around the arm and secure this point firmly.
• Step 3: The first step to preparing for the test is to clean the area with an antibacterial and antiseptic wipe.
• Step 4: They will then insert a needle attached to a vial used for blood storage.
• Step 5: Once the vial is full, the technician will pull out the vial, clean the area with another antiseptic and antibacterial swab.
• Step 6: The blood is then sent for evaluation to a lab where the biochemist will evaluate the sample and send the results to the hospital.

During your subsequent appointment with the doctor, they will discuss the results and provide relevant information based on the results.

Note: The test does not have any side effects. Please discuss any concerns you have about the test, results and action required based on the results with your primary healthcare physician.

What Triple Screen Test Looks For

This is an indicative test that provides the doctors with an insight on what course to take if an abnormality is detected. This test measures levels of ACG and determines if the hCG and estriol levels are normal or not. This result is then supplemented with the mother’s age, weight, the gestation period of pregnancy and ethnicity to come to a diagnosis.

Precautions to Take During the Test

It is important that you share information that is accurate with your doctors. A change in information can alter the results of the tests and how they are interpreted.

Doctors will take the required precautions while drawing blood to ensure the fetus is not affected by any blood-borne pathogens by using new needles, using antiseptic and antibacterial wipes and if required putting you on the necessary antibiotics.

Benefits of Triple Marker Screen Test

Getting a triple marker screen test done will greatly benefit women who are above the age of 35. The major benefit of this test is that it helps predict numerous birth defects your baby may have or helps you prepare for these conditions in advance. Some of these genetic disorders and abnormalities include:

• Trisomy 18 aka Edwards Syndrome: A chromosome abnormality
• Down Syndrome: A condition in which extra genetic material from chromosome 21 is present in the cell.
• Neural Tube Defects: Birth defects involving the brain, spine and the spinal cord.
• Multiple Babies (Twins or Triplets): While it is not a dangerous condition to be diagnosed of, knowing you are carrying more than one baby is a good heads-up in terms of planning your prenatal vitamins intake, diet, and other things during pregnancy.

This test is important if you have a family history of birth defects, have diabetes and use insulin, had a viral infection or have used harmful drugs during pregnancy.

Side Effects and Risks to the Mother or Baby

There are no known side effects or risks to either the mother or the foetus. Since the amount of blood drawn is very little, even the loss of blood is not significant enough to affect the mother’s health.

Interpretation of the Test Results

The results of the triple marker tests are indicative of the risks the developing baby may be facing. The results are dependent on the following factors:

• Age of the mother
• Ethnicity
• Mother’s weight
• If the mother is diabetic
• Multiple or single pregnancies
• Number of weeks of pregnancy

Your OB/GYN will be trained on how to read triple marker test results and will tell you if the triple marker test report analysis is negative or positive. Your doctor will also tell you that the test has many false positives and further testing will be required even if you do not see a normal value for the triple marker test.

What Does a Negative Screen Mean

A negative screen result probably means that your foetus is at a low risk of developing a birth defect such as neural tube defects, Down syndrome, and Trisomy 18. However, this is no guarantee of a normal birth or a perfectly healthy baby.

What Should You Do if the Test Results Are Abnormal

Your doctor will definitely want to conduct a few more tests to determine the exact nature of the abnormality your baby faces. The first of these tests will most likely be an ultrasound where the age of the foetus will be determined. Along with this, special attention will be paid to the foetus’s brain, spinal cord, kidneys and heart to check for any problems.

The triple marker test results low-risk nature ensures that even if the results are abnormal, the doctors will be able to either prepare you for the conditions to come or help cure it.

What Other Reasons Call for Further Testing

Getting a triple marker test done can help not just identify or diagnose possible birth defects and genetic conditions but more importantly, it can help a parent prepare for them. One of the biggest reasons to get a test done is to help potential parents prepare for a life with a child who has special needs. This is done by:

• Educating parents about the needs of a specially-abled child.
• Connecting parents to support groups and therapist.
• Raising awareness about a possible condition.
• Giving parents an opportunity to consider all their options including surgery, medication and alternative therapy.

Alternative Screening Tests

Some parents may opt for alternative screening tests to further understand the diagnosis or get a second opinion. Getting tests like a prenatal ultrasound done can help parents confirm a diagnosis. Talk to your primary healthcare physician for a list of alternative tests to help you make the right choice about which test to opt for according to your needs.

Being prepared is the best way to tackle possible challenges. Knowing if your child is healthy or not is the first step to being prepared for your life ahead together. Knowing their condition and what the next steps are is also key to facing these challenges. The triple marker test helps prepare as well as rule out possible problems concerning your child’s health and welfare. Getting it done has no side effects considering this is all reward and no risk.