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What is a Double Marker Test, and Should You be Concerned?

Through various tests and screening, an expectant mother can get slight hints of how healthy the pregnancy will be. One of such common diagnostic tools is the double marker test which helps the mother learn many things about the baby beforehand without any concern, and it is quite inexpensive.

It's normal to be apprehensive to take such tests, but they are necessary for the baby's health. So, here is a comprehensive guide for the double marker test in pregnancy- know the requirements, procedure and price.

Overall, the double marker test in pregnancy is necessary to rule out any possibilities of severe disorders like Edwards’ syndrome or Down syndrome, which can affect any child's development.

Why is the Double Marker Test Done?

A double marker test in pregnancy recommends for detecting any abnormalities associated with the foetus. This pregnancy test checks the human chorionic gonadotropin, i.e. free Beta hCG, and pregnancy-associated plasma protein-A, i.e. PAPP-A. The test helps to screen out any neurological disorders present in the foetus, including Down syndrome and Edwards’ syndrome. 

When is the Double Marker Test Required?

The double marker test in pregnancy is not one of the mandatory tests that every expectant mother should undergo, but it is recommended. Most doctors prescribe this test during the first trimester of pregnancy to prevent any unforeseen complications in the baby after birth. 

The window for undergoing this type of test is relatively small, and in most cases, one’s healthcare provider will be able to suggest a suitable time. This procedure is generally performed from the gestation age of 11 to 14 weeks. This test is highly recommended for women who are over the age of 35 years or those with elevated risks of chromosomal issues. 

What is the Procedure Followed for the Double Marker Test in Pregnancy?

The procedure for the double marker test is simple. This test begins with an ultrasound known as nuchal translucency (NT) scan which examine the clear tissue at the back of the neck of your baby accompanied by a simple blood test to determine the two markers in a pregnant woman.

The two markers included in the double marker test in pregnancy are as follows:

  • The human chorionic gonadotropin, i.e. Free Beta hCG, is the first marker of the test. High levels of Free Beta hCG convey that the foetus is at risk of developing Trisomy that leads to Down syndrome. 

  • The pregnancy-associated plasma protein-A, i.e. PAPP-A, is the second marker of the double marker test in pregnancy. Low levels of PAPP-A convey that the foetus is prone to Down syndrome. 

The definitions of Down syndrome, Trisomy 13 and Trisomy 18 are as follows:

  • Down syndrome

Down Syndrome is a genetic disorder caused when an abnormal division of cells occurs in the foetus resulting in the presence of a partial or full copy of chromosome 21. The severity of this disorder ranges from lifelong intellectual disability to heart disorders. 

  • Trisomy 18 and Trisomy 13

Trisomy 18 and Trisomy 13 comprise various congenital disabilities, including intellectual disability and severe health problems. The babies born with it are prone to the risk of dying by the age of 1 year. 

Levels of hCG and PAPP-A may be either higher or lower than “normal” in pregnancies with these chromosomal abnormalities.

Double Marker Test vs. NT Scan - What is the Difference?

Criteria

Double marker test

NT scan

Prenatal Down syndrome detection

60% of cases

70% of cases

Why is it done?

For determining birth defects by measuring the nuchal translucency value

For determining chromosomal abnormalities

How is it done?

It is done through ultrasound.

It is done through a blood test.

 

What is the range for hCG and PAAP – A?

The range of hCG and PAAP-A shows low-risk, high or moderate or high results. Low risk means that there is a low probability of the baby having chromosomal abnormalities.

What Results Expect after the Double Marker Test?

The results of the double marker test generally fall under three categories: low risk, moderate/normal and high risk.

If the result of the double marker test conveys a lower risk, it means that there is a low probability for the baby to have chromosomal abnormalities. 

While if the expecting mother receives a normal or moderate result, then she is recommended to go for further testing. However, the recommendation is only given if the family has a past history of chromosomal abnormalities or if the mother wants reassurance by learning more about it. 

The high-risk result indicates that the baby is more likely to get chromosomal abnormalities. In such cases, further tests are conducted, and the mother can decide to abort the pregnancy if she is not ready for it. 

Cost of Double Marker Test 

The double marker test cost varies depending on hospital, city, availability and quality. For instance, in Mumbai, the test cost starts at Rs. 1800, for Pune, it starts from Rs. 1280, for Delhi, it starts from Rs. 1231, for Noida, it starts from Rs. 1350, and for Hyderabad, it starts from Rs. 760. Overall, the ranges are somewhere between INR 2,500 and 3,500, which includes the cost of an ultrasound scan, blood test and blood test analysis. 

Benefits of the Double Marker Test

The double marker test helps assess the following in an unborn baby:

Helps in the early detection of abnormalities

A double marker test is done to detect Down syndrome, Trisomy 18 and Trisomy 21. Additionally, it can help in the early detection of conditions like preeclampsia, foetal growth restriction and placental restrictions.

Helps in making vital decisions about the pregnancy

It helps in the early detection of abnormalities in the baby and assists the doctor to find the best treatment option. This will also make the mothers aware of the complications at an early stage so they can make an early call regarding the continuation/termination of pregnancy, while reducing the complications for both the baby and mother. 

Risks Associated with the Double Marker Test

The test is a non-invasive type; however, following the instructions of the doctor is necessary.

How Should One Prepare for the Double Marker Test?

The double marker test can be treated as a simple blood test and is not at all complicated. Changing one’s lifestyle is not necessary before taking the test. Moreover, the test is a non-fasting type of test; so one can drink or normally eat before the appointment unless instructed. 

However, one should let the doctor be aware of any pre-existing allergies or medications that can create an issue. The simple nature of the test is explained through its procedure that starts with an ultrasound scan. Following the scan, a nurse takes the blood sample, which is analysed. Overall, there are no special requirements for this test.

Results of the Double Marker Test

The designated healthcare provider will use various reports such as ultrasound exams, prenatal down syndrome pregnancy, blood test results and the age factor to gauge the risks of the baby in the first trimester. The test results could be either negative or positive, along with the possibility of Down syndrome. 

Conclusion

Undergoing a double marker test in pregnancy is highly recommended, and one should remember that the test results only predict the overall risks, if any. 

The double marker test cost is minimum, and one can get an idea of the risk of disorder. Consulting a professional healthcare provider and genetic professional is necessary to know whether additional tests are required.