Quadruple screening test
You have been given this information leaflet because combined screening cannot be offered in this pregnancy. This might be because:
• You are more than 14 weeks pregnant. After 14 weeks and 1 day of pregnancy it is not appropriate to offer the combined screening test.
• Your baby is lying in a position at the dating scan where the nuchal translucency (the appearance of the pocket of fluid under the skin behind the baby’s neck) cannot be measured.
The combined screening test relies on an accurate nuchal translucency measurement, alongside a blood test taken from you to measure biomarkers in your blood and information about maternal demographics.
Without having all this information, a combined screening test cannot be offered. In these cases, your screening choices are:
1. Quadruple screening for Down’s syndrome only.
2.No quadruple screening (please note Edwards’ syndrome and Patau’s syndrome will be screened for as part of your routine anomaly scan around 20 weeks of pregnancy.)
What does the quadruple test involve?
A sample of your blood will be taken to measure four substances in your blood:
• Alpha-fetoprotein (AFP)
• Total human chorionic gonadotrophin (hCG)
• Unconjugated oestriol (uE3)
• Inhibin-A (inhibin)
What does the quadruple test screen for?
• Down’s syndrome: The quadruple test screens for Down’s syndrome only. In pregnancies with Down’s syndrome, AFP and uE3 levels tend to be low and hCG and inhibin levels tend to be raised. It is important to note the quadruple screening test is not as accurate as the first trimester combined screening test. The combined test has a detection rate of 85% and the quadruple test has a detection rate of 80%
Can the Screening test harm me or my baby?
The screening test cannot harm you or your baby but it is important to consider carefully whether to have the test. The screening test cannot tell for definite whether your baby does or doesn’t have Downs syndrome but it can provide other important information that may lead to other important decisions. For example you may be offered other diagnostic tests like an amniocentesis that can tell for certain if your baby does or doesn’t have Downs syndrome but these tests have a risk of miscarriage. Some women may look into private screening tests for example Non invasive prenatal testing that screens for Down’s syndrome, Edwards Syndrome and Patau’s Syndrome. This is only currently available within the NHS for women that have an increased chance screening result.
Please refer to the Screening tests for you and your baby leaflet which you should have been told about in early pregnancy for further information or contact your midwife.
Screening tests for you and your baby (STFYAYB) - GOV.UK (www.gov.uk)
Twin pregnancies and quadruple screening
Women with a twin pregnancy considering quadruple screening should have a more detailed conversation with the screening team or obstetrician before having the test undertaken. This is due to the complexities and limitations of the quadruple test in this scenario and differences in the detection rate of the test in twin pregnancies.
When should quadruple screening occur?
Quadruple screening is ideally taken at around 15 or 16 weeks of pregnancy (from 14 + 3 is acceptable). The last opportunity to have quadruple screening is 20+0 days of pregnancy. If you would like to have a quadruple screening test please ensure you have an appointment to have this test taken within this timeframe.
Please contact the Screening Team on 01253 953639 at your earliest convenience to discuss your options/arrange/decline an appointment for quadruple screening.
Quadruple screening results
Results from your quadruple test take around 1 - 2 weeks to be received. Your results will be uploaded to Badgernotes. If your screening result requires further discussion, the screening team will phone you (please note the hospital phone number comes up as withheld). Your quadruple screening result will identify if your pregnancy is lower or higher chance of having a baby with Down’s syndrome.
