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2. Quadruple marker
3. Trisomy confirmation
Targeted Specialties
Gynecologists (Obstetricians)
IVF specialists
Stages of Pregnancy
What is NT?
Remember,
This test is NOT a diagnostic test (it cannot tell whether the baby has any of
the above conditions); it only identifies the risk of the baby being affected. A
confirmatory test may be needed when the screening test is positive (high
risk)
Downs syndrome or Trisomy 21
Trisomy 18/13
Report is
generated
by
PRISCA.
This is a
software
for risk
calculation
Reporting and Interpretation of Results
82 to 87%
First Trimester
Screening by FMF
(Fetal Medicine
Foundation)
• The FMF has set up a process for certification in the measurement of fetal
NT to ensure that those performing this ultrasound examination have been
adequately trained to do so and that high standards of performance are
maintained by continuous education and audit
• The only condition for ongoing certification and use of the software is
provision of NT data and images by the sonographer for the purposes of
audit
• FMF has defined guidelines and protocols for NT measurement and this
protocol is widely respected globally
• AFP (Alpha-fetoprotein)
• uE3 (unconjugated Estriol)
• hCG (Human Chorionic gonadotrophin)
• AFP (Alpha-fetoprotein)
• uE3 (unconjugated Estriol)
• hCG (Human Chorionic gonadotrophin)
• Inhibin A
AFP (Alpha-fetoprotein)
• AFP is a substance made in the liver of the fetus and some amount gets
into the mother’s blood
• Measuring levels in maternal serum help in screening for Downs syndrome
or Edward syndrome or neural tube defects
• Normally, low levels of AFP can be found in the blood of a pregnant woman.
No AFP (or only a very low level) is generally found in the blood of healthy
men or healthy, non pregnant women.
• In men, non pregnant women, and children, AFP in the blood can mean
certain types of cancer, especially cancer of the testicles,
ovaries, stomach, pancreas, or liver are present
• AFP levels are increased in Neural tube defects and decreased in Down
syndrome and Edward syndrome
uE3 (Unconjugated Estriol)
• Estriol is a hormone produced by the placenta, using ingredients made by the fetal
liver and adrenal glands
• Estriol levels are reduced in pregnancies with Down syndrome or Edward syndrome
Inhibin - A
• Is a protein secreted by the ovary, and is designed to inhibit the production of the
hormone FSH by the pituitary
• The level of inhibin A is increased in the blood of mothers of fetuses with Down
syndrome
• A practical advantage of the use of inhibin A as a screening marker is the very small
change in average levels of inhibin A with increasing lengths of gestation between 15
and 18 weeks in women with unaffected pregnancies. Inaccuracies in estimating the
length of gestation will therefore have a much smaller effect on the calculation of risk
estimates than would be the case with a marker such as unconjugated estriol
When is Triple/Quadruple marker done?
Remember,
These tests are NOT diagnostic tests (they cannot tell whether the baby has
any of the above conditions); it only identifies the risk of the baby being
affected. A confirmatory test may be needed when the screening test is
positive (high risk)
Neural Tube Defect (NTD)
Report is
generated
by
PRISCA.
This is a
software
for risk
calculation
Reporting and Interpretation of Results
• Peripheral blood
• Weight
• It does NOT mean that the baby necessarily has one of these
conditions