Triple Marker Test

CERULOPLASMIN- triple marker

Last Updated December 20th, 2021

What is the Triple Marker Test?

A Triple marker test also known as a Tripler marker screen test is conducted during pregnancy. The test is done to diagnose if there are any possible genetic or chromosomal disorders in the developing baby.

What does a Triple Marker test do?

A Triple marker test also called a Triple test or an AFP Plus test measures the level of three essential substances present in the placenta.
– AFP or alpha-fetoprotein.
– HCG or human chorionic gonadotropin.
– Estriol 

What are the factors governing a Triple Marker test?

The Triple marker test is done taking into consideration several factors such as:
– Age of mother.
– Height and weight
– Gestation period
– Ethnicity

Why is a Triple Marker test also called a Screening test?

A Triple marker test is called a screening test simply because it helps to screen or diagnose possibilities of fetal abnormality during pregnancy. The results are not conclusive but purely indicative of certain abnormalities or defects. A Triple marker screening test helps doctors to take further tests to ascertain whether the patient has any problem in her pregnancy or not.

Why do I need a Triple Marker Test?

Your OB/GYN or health provider may suggest you a Triple marker test due to the following reasons:

– You are diabetic and are on regular insulin dosage.
– Over 35 years of age.
– Any past history of birth defects or genetic disorders in the family.
– You were on any pre-natal medication.
– Any drugs with side effects.
– You had a viral infection during pregnancy.
– Exposure to high levels of radiation.

What are the other reasons for a Triple Marker test?

A Triple marker test is done not only to identify the birth defects of your unborn child, but also to educate and prepare you and your partner to take care of your child with special needs. Here are some of the reasons why a Triple marker test is important:

– Helps parents prepare for the needs of their special child.
– Parents can connect to support groups or take the help of a therapist.
– Makes parents aware of situations that may arise during their parenting.
– Explains parents about alternative treatment, surgery, medication, and other therapy.

When should I get a Tripler Marker Test?

A Triple marker test is done between 15 and 20 weeks of pregnancy. However, for more accurate results, the test should be done between 16 to 18 weeks of pregnancy.

What does a Triple Marker test indicate?

A Triple marker test helps to indicate a number of birth defects such as:

– High levels of AFP protein produced by the fetus. If the AFP is high then it is suggestive of possible neural tube defect, spina bifida, or congenital defect called anencephaly.

– To detect multiple pregnancies. High levels of HCG present in the placenta denote multiple pregnancies.

– HCG is a hormone that is present in the placenta. Low levels of HCG denote ectopic pregnancy or the possibility of a miscarriage.

– Estriol levels. Estriol is an estrogen that is produced by the fetus. Low levels of estriol along with abnormal levels of HCG and AFP levels indicate a possible Down Syndrome in the baby (Trisomy 21) or Edwards Syndrome (Trisomy 18).

– Estriol levels also help to indicate other chromosomal abnormalities.

– To detect advanced pregnancy – Based on your test results, your OB/GYN will tell you whether your test is negative or positive. If your test results are positive, your doctor will ask you to do further tests.

How do I prepare for a Triple Marker test?

A Triple marker test is fairly simple. There are no drinking or food restrictions before or after the test.

How common are fetal abnormalities in India?

India ranks number one in the case of neonatal deaths; almost 750,000 newborn babies die every year. The first 4 weeks or 28 days are extremely critical for a newborn as most fatalities in this demography occurs within this time period. The risk of death is almost 30x higher. In the year 2013, more than 60,000 cases of neonatal deaths were caused by fetal abnormalities in India. India lacks a national birth defects surveillance, indicating that there is no data on the magnitude of fetal abnormalities/anomalies in the country. 

How is a Triple Marker test done?

A Triple marker test is like a simple blood test. The test can be administered at the laboratory, doctor’s clinic, or at the hospital. Here are a few steps that will help you understand how the test is done.

– Your nurse or technician will ask you to stretch your arm and make a fist. This helps to find your vein.

– A rubber band or strap is used to tighten your arm to make your vein more visible and accessible for the blood to be withdrawn.

– Your technician will then find a patch of your skin and clean the area with an antiseptic patch or solution.

– A needle with a vial is inserted into the area to draw the blood.
The needle is removed once the vial is full.

– The puncture site is cleaned with a cotton swab and a band-aid is placed on the area.

– Your technician will then send the blood sample to the laboratory for examination.

Does a Triple marker test have any risk or side effect?

No, a Triple marker test does not pose any risk or threat to the mother or to the fetus. The blood that is withdrawn is very small in amount and thus does not affect the health of the mother.

What is the cost of a Triple Marker test in India?

A Triple Marker test can cost anywhere between Rs 1200 to Rs 4,200. The cost depends on the laboratory, hospital, city, and also factors like quality and availability of the test.

How long does it take to get the Tripler Marker Test results?

You will get your results usually within 2 to 4 days of your test

What is the normal value for the Triple Marker test?

Triple marker test normal range taken at 32 weeks.



AFP Male and Female 0.20 ng/ml-250 ng/ml
HCG Female 4,060 mIU/ml-165400 mIU/ml
Estriol Female Less than 14.60 ng/ml (third trimester)

The above chart represents the normal range values of AFP, HCG, and Estriol. Any value more or less than the normal range is considered to be a matter of concern and the physician needs to be consulted immediately.

What do I do after I receive my Triple Marker test results?

Couples are advised to consult their OB/GYN or physician even if their test results come out negative. Many times, the Triple Marker test results come out as false positive. So, it is best to seek the professional advice of the medical practitioner who knows how to read a Triple marker report.

If your Triple marker test report is positive or shows abnormal readings, then your physician may ask you to do the following tests:

– If your test readings show high AFP levels, your doctor will suggest an ultrasound examination. The ultrasound will check the kidney functioning, heart, brain, spinal cord, neural tubes and also detect the age of the fetus.

– An amniocentesis test that checks the fluid around the baby. In this case, a thin hollow needle is used to withdraw a sample of the amniotic fluid to detect any genetic abnormality or infection.

What does a negative Triple Marker test mean?

A negative Triple Marker test indicates that your baby is probably safe from Down syndrome, neural tube defect, Edwards Syndrome, and other chromosomal defects.

Do I need to consult a doctor even if my Triple Marker test comes out negative?

Yes, even if your test result comes out negative, it does not mean that your baby will not have any birth defect. It is wise to seek the advice of your OB/GYN who will explain the test results to you and may ask for further tests as well.

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