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The available blood tests from the first trimester screen can test for plasma protein A and human chorionic gonadotropin. The second trimester screen looks at specific blood markers, to include the estriol, inhibin and human chorionic gonadotropin hormones and often consists of Alpha-fetoprotein (AFP) screening.
The triple test, also called triple screen, the Kettering test or the Bart's test, is an investigation performed during pregnancy in the second trimester to classify a patient as either high-risk or low-risk for chromosomal abnormalities (and neural tube defects). The term "multiple-marker screening test" is sometimes used instead.
It gives an accurate risk profile very early. A second blood screen at 15 to 20 weeks refines the risk more accurately. [13] The cost is higher than an "AFP-quad" screen due to the ultrasound and second blood test, but it is quoted to have a 93% pick up rate as opposed to 88% for the standard AFP/QS.
Typically, MSAFP is measured in the beginning of the second trimester (14–16 weeks). It may be measured alone or as part of a package of routine prenatal screening tests, such as a triple test or quad test. Because MSAFP test results must be interpreted according to the gestational age, they often are reported in terms of multiple of the ...
NIPT can determine paternity and may be able to determine fetal sex earlier in gestation than previous tests such as ultrasounds. It is recommended that the test be performed towards the end of the first trimester to the beginning of the second trimester, when there is enough cffDNA circulating in the mother's bloodstream to be detectable. [23]
As an example, Alpha-fetoprotein (AFP) testing is used to screen for a neural tube defect (NTD) during the second trimester of pregnancy. If the median AFP result at 16 weeks of gestation is 30 ng/mL and a pregnant woman's AFP result at that same gestational age is 60 ng/mL, then her MoM is equal to 60/30 = 2.0.
In another study values of 79.6% and 2.7% for the combined screening were then improved with the addition of second trimester ultrasound scanning to 89.7% and 4.2% respectively. [13] A further study reported detection of 88% for trisomy 21 (Down syndrome) and 75% for trisomy 18 (Edwards syndrome), with a 3.3% false-positive rate. [14]
An amniocentesis is typically performed in the second trimester between the 15th and 20th week of gestation. [5] Women who choose to have this test are primarily those at increased risk for genetic and chromosomal problems, in part because the test is invasive and carries a small risk of pregnancy loss. [5]
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