Double Marker Test: A Comprehensive Guide

Test Overview

Pregnancy is a time of joy and anticipation, but also of careful monitoring and medical assessments to ensure the well-being of both the mother and the developing baby. One of the key tools in early prenatal screening is the double marker test, a non-invasive blood test that provides crucial insights into the baby’s chromosomal health. This comprehensive guide explores every detail about the double marker test in pregnancy, from its purpose and procedure to interpreting results, associated costs, and more.

What Is the Double Marker Test?

The double marker test is a type of prenatal screening performed during the first trimester of pregnancy to assess the likelihood of chromosomal abnormalities in the fetus. It specifically evaluates the risk of three primary chromosomal conditions:

• Down syndrome (Trisomy 21)
• Edward syndrome (Trisomy 18)
• Patau syndrome (Trisomy 13)

These conditions are caused by extra copies of chromosomes and can result in developmental delays, intellectual disabilities, and physical abnormalities. Early detection is key to informed decision-making, and the double marker test serves as a critical step in identifying high-risk pregnancies.
The test gets its name from the two key biochemical markers it measures in the mother's blood:

Free Beta-human Chorionic Gonadotropin (Free β-hCG) – A hormone produced by the placenta. Elevated levels may be associated with a higher risk of Down syndrome.

Pregnancy-Associated Plasma Protein-A (PAPP-A) – A protein that supports the development of the placenta. Lower levels may be associated with chromosomal abnormalities such as Trisomy 18 or 13.

The test is generally combined with an ultrasound scan, known as the nuchal translucency (NT) scan, which measures the clear (translucent) space at the back of the baby’s neck. A larger NT measurement can also indicate a higher risk of chromosomal abnormalities. When used together, the accuracy of the screening increases significantly.

Importantly, the double marker test is a screening test, not a diagnostic one. It does not provide a definitive answer but rather an estimate of risk. Abnormal or high-risk results are followed up with confirmatory diagnostic tests like Non-Invasive Prenatal Testing (NIPT), amniocentesis, or chorionic villus sampling (CVS).

How Much Does the Double Marker Test Cost?

Double Marker Test Price in Different Cities

Although the double marker test price might seem like an extra expense, it provides invaluable information that can significantly influence the outcome of a pregnancy. The cost of the Double Marker Test can vary based on factors such as your location, the diagnostic centre you choose, and whether the test is included in a prenatal screening package.

Several elements can influence how much you pay for the Double Marker Test:

Where You Live: Prices may be higher in metropolitan hospitals compared to smaller towns or semi-urban areas.

• Type of Test Package: Some
•  labs include the Double Marker Test as part of a comprehensive prenatal screening or first-trimester screening panel, which can affect the overall price.
• Diagnostic Centre Reputation: Well-known facilities like Apollo Diagnostics may offer exclusive discounts or packages through platforms such as Apollo 24|7.
• Online Booking Offers: Many diagnostic providers, including Apollo 24|7, offer reduced rates or added benefits if you book the test through their website or mobile app.

For the most accurate and up-to-date Double Marker Test pricing and any available offers, visit the Apollo 24|7 website or mobile app to schedule your test conveniently.

Why is the Double Marker Test Important?

The primary aim of the double marker test is to identify the risk of chromosomal abnormalities at an early stage of pregnancy. While it does not provide a definitive diagnosis, it helps stratify pregnancies into low-risk and high-risk categories.

Here’s why the test is important:

1. Early Detection of Genetic Disorders

The double marker test helps detect the risk of genetic conditions such as:

• Down syndrome (Trisomy 21) – Most common, causing intellectual disability, distinct facial features, and heart defects.
• Edward’s syndrome (Trisomy 18) – Affects multiple organs and has a low survival rate.
• Patau syndrome (Trisomy 13) – Involves severe intellectual and physical disabilities.

2. Non-invasive and Safe

Unlike invasive diagnostic procedures such as amniocentesis or chorionic villus sampling (CVS), the double marker test poses no risk to the mother or the fetus.

3. Better Planning and Informed Choices

Results help healthcare professionals and parents make informed decisions, such as:

• Whether to proceed with further testing
• Preparing emotionally and medically for a child with special needs
• Making difficult decisions early in pregnancy, if necessary

4. Complement to NT Scan

When paired with a nuchal translucency scan, the double marker test significantly improves the sensitivity and specificity of early screening.
As prenatal care advances, early screenings like the double marker test have become instrumental in improving pregnancy outcomes and guiding timely interventions.

Who Should Get the Double Marker Test?

The double marker test is routinely recommended for all pregnant women during their first trimester. However, it is particularly important in certain high-risk situations:

• Women aged 35 years or older, as the risk of chromosomal abnormalities increases with maternal age.
• Pregnancies achieved through assisted reproductive technologies like IVF.
• Women who have previously had a baby with genetic or chromosomal disorders.
• If there is a family history of genetic disorders.
• When the NT scan shows abnormal findings or increased thickness.
• Women with a history of multiple miscarriages.
• If the pregnancy is the result of a consanguineous marriage.

Even for women who do not fall into these high-risk categories, the test is often offered as part of routine first-trimester screening to ensure comprehensive prenatal assessment.

How to Prepare for the Double Marker Test?

One of the advantages of the double marker test is that it requires minimal preparation. Nevertheless, following a few basic steps can help ensure a smooth and accurate screening:

• Fasting is not required: You can eat and drink normally before the test.
• Share medical history: Inform your healthcare provider about any existing medical conditions or medications you are taking.
• Provide accurate gestational age: Make sure the doctor has the correct gestational age, usually based on your last menstrual period or early ultrasound.

Bring previous test results: If you’ve already had your NT scan, bring the report to help integrate the results for a more accurate risk analysis.
The ideal time for this test is between the 10th and 14th week of pregnancy. Accurate dating is vital to ensure reliable interpretation of hormone levels.

What Is the Procedure for the Double Marker Test?

The double marker test procedure is simple, safe, and quick:

Consultation: Your obstetrician or gynaecologist will recommend the test based on your pregnancy timeline and medical history.

• Sample Collection: A blood sample is drawn from a vein in your arm by a trained laboratory technician.
• Laboratory Analysis: The sample is sent to the lab, where the levels of Free β-hCG and PAPP-A are measured.
• Risk Calculation: The lab combines the marker levels with your age, gestational age, and NT scan measurements (if available) to calculate the risk.
• Report Delivery: Results are usually ready within 3 to 5 working days.

The test poses no risk to the mother or baby and can be done during a routine prenatal visit or at a diagnostic centre.

Understanding Double Marker Test Results

The results of the double marker test are usually reported as a risk ratio and categorised into two main groups:

• Low Risk: Suggests a low probability of chromosomal abnormalities. No further testing is typically required unless there are other concerns.
• High Risk: Indicates a higher likelihood of conditions like Down syndrome. Your doctor may recommend further tests such as NIPT, amniocentesis, or CVS.

The interpretation of the test results takes several factors into account:

• Maternal age
• Foetal gestational age
• NT scan measurement (if performed)
• Free β-hCG levels
• PAPP-A levels
• Medical and family history

Example Result Interpretation:

• High Free β-hCG + Low PAPP-A: May suggest increased risk for Down syndrome (Trisomy 21).
• Low levels of both markers: May suggest risk for Edward syndrome (Trisomy 18) or Patau syndrome (Trisomy 13).
• It’s important to remember that a high-risk result is not a diagnosis. It simply means that further testing is warranted to confirm or rule out a condition.

What Factors Affect the Double Marker Test Results?

The accuracy of the double marker test in pregnancy can be influenced by various maternal and biological factors:

• Incorrect gestational age estimation
• Multiple pregnancies (twins or more)
• Maternal obesity or low body weight
• Ethnicity
• Certain medical conditions (e.g., diabetes, thyroid disorders)
• Smoking and lifestyle habits

Medication use during pregnancy

To reduce the likelihood of incorrect results, ensure that your dating scan is accurate and inform your healthcare provider of any relevant health issues.

How to Access Your Double Marker Test Report on Apollo 24|7

If you've taken the double marker test at Apollo Hospitals or through the Apollo 24|7 platform, accessing your results is quick, easy, and fully digital. Apollo’s patient-centric online platform allows you to securely view, download, and share your reports from the comfort of your home.

Follow these simple steps to access your double marker test report:

1. Wait for the Notification: Once your double marker test results are ready, you will receive a notification via SMS and/or email from Apollo 24|7. This ensures you're immediately informed as soon as your report is available.
2. Log in to Apollo 24|7: Visit the official Apollo 24|7 website (www.apollo247.com) or open the Apollo 24|7 mobile app. Log in using your registered mobile number or email ID. Ensure you use the same credentials provided at the time of booking your test.
3. Navigate to ‘Diagnostics’ or ‘Medical Records’: Once logged in, go to the “Medical Records” or “Diagnostics Reports” section in your dashboard. This section stores all your lab test reports and medical documentation.
4. Locate the Double Marker Test Report: Scroll through your available reports or use the search function to type in “Double Marker Test”. This will help you find your specific report quickly and efficiently.
5. View and Download Your Report: Click on your double marker test result to view the detailed report. It will include:

• Your hormone levels (Free β-hCG and PAPP-A)
• Risk ratio
• Reference ranges
• Interpretation of the findings

6.You can also download the report as a PDF file for your records or share it digitally with your gynaecologist or healthcare provider.
Apollo’s digital ecosystem ensures that your pregnancy journey is well-supported with timely information, expert advice, and secure access to your medical records anytime, anywhere.