Some serum markers in second trimester of pregnancy are useful in determining risk of developmental and chromosomal anomalies; these include Alpha fetoprotein (AFP), Human chorionic gonadotrophin (HCG), Unconjugated estriol (
uE3) and Inhibin A (Inh-A).
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Maternal Serum Screening: Approved Standard--Second Edition (I/LA25-A2) addresses the steps required to provide reliable screening and reporting using examples of serum markers currently in common use (AFP, hCG,
uE3, inhibin A, PAPP-A).
Screening for trisomy 18 has been in practice since the 1980s, when unconjugated estriol (
uE3) and human chorionic gonadotropin (hCG) were added to the measurement of alphafetoprotein (AFP) as part of second trimester serum maternal screening protocols for Down syndrome.
Second-trimester maternal serum screening currently includes a combination of 4 markers and is known as the "quad test." These markers include AFP, human chorionic gonadotropin (hCG), unconjugated estriol (
uE3), and inhibin A.