Apollo Diagnostics | NABL-Certified Lab | No Fasting Required | USG Report & Doctor's Prescription Required
What is a Triple Marker Test?
The Triple Marker Test (also called the Triple Screen or Maternal Serum Screen) is a second trimester prenatal blood test performed between 15 and 20 weeks of pregnancy. It measures three specific substances in the mother's blood — AFP (Alpha-fetoprotein), HCG (Human Chorionic Gonadotropin) and uE3 (Unconjugated Estriol) — and combines these with maternal age, gestational age and body weight to calculate the statistical risk of chromosomal abnormalities and neural tube defects in the developing baby. It is the standard prenatal screen for women who missed the first trimester Dual Marker window.
⚠ Important — bring these to your appointment:
- Your latest ultrasound (USG) report confirming gestational age and fetal measurements
- Your gynaecologist's prescription or referral
- Your exact date of birth and body weight (both are required calculation variables)
- Your LMP (Last Menstrual Period) date
Components and Clinical Significance of the Triple Marker
The strength of this test lies in the combined analysis of three markers:
- AFP (Alpha-Fetoprotein) — a protein produced by the developing baby's liver and yolk sac. High AFP (above 2.5 MoM) indicates risk of open neural tube defects (Spina Bifida, Anencephaly) or abdominal wall defects. Low AFP suggests increased risk of Down Syndrome (Trisomy 21) or Edwards Syndrome (Trisomy 18).
- HCG (Human Chorionic Gonadotropin) — produced by the placenta. Elevated HCG (above 2.0 MoM) is associated with Down Syndrome. Low HCG suggests Edwards Syndrome or Patau Syndrome.
- uE3 (Unconjugated Estriol) — an oestrogen produced jointly by the placenta and the fetal adrenal glands and liver. Low uE3 (below 0.5 MoM) is associated with Down Syndrome and Edwards Syndrome. Very low uE3 can indicate steroid sulphatase deficiency or Smith-Lemli-Opitz syndrome.
Triple Marker Pattern by Condition
| Condition | AFP | HCG | uE3 |
|---|---|---|---|
| Down Syndrome (Trisomy 21) | Low – (0.7 MoM) | High – (2.06 MoM) | Low – (0.74 MoM) |
| Edwards Syndrome (Trisomy 18) | Low | Low | Low (all three low) |
| Open Neural Tube Defect (Spina Bifida) | Very High (>2.5 MoM) | Normal | Normal |
| Anencephaly | Very High | Normal | Normal or Low |
| Abdominal Wall Defect (Gastroschisis) | Very High | Normal | Normal |
| Normal Pregnancy | Normal (1.0 MoM) | Normal (1.0 MoM) | Normal (1.0 MoM) |
Results are expressed as MoM (Multiples of the Median). The risk calculation software combines all three marker MoM values with maternal age, weight and gestational age to generate a final risk ratio for each condition.
Triple Marker vs Dual Marker — When to Choose Which
Understanding the two prenatal biochemical screening options:
- Dual Marker (11–14 weeks) — First trimester. Measures Free Beta-HCG + PAPP-A. Combined with NT scan gives 85–90% detection rate for Down Syndrome. The preferred first choice when possible.
- Triple Marker (15–20 weeks) — Second trimester. Measures AFP + HCG + uE3. Detection rate for Down Syndrome approximately 70–75%. Ideal timing 16–18 weeks. The standard option when the first trimester window (11–14 weeks) has passed.
- Quad Marker (15–20 weeks) — Adds Inhibin-A to the Triple Marker for a Quad Screen with higher detection rate (about 80%) for Down Syndrome. Some centres offer this instead of Triple Marker.
- Both Dual + Triple together — Integrated screening. Combining first and second trimester markers gives the highest detection rate (about 94–96% for Trisomy 21) with the lowest false positive rate. Discuss with your gynaecologist.
- NIPT (10+ weeks) — The most accurate non-invasive option (above 99% for Trisomy 21). Recommended when Dual Marker or Triple Marker is high-risk, or when maximum accuracy is desired.
Triple Marker Results — Low Risk vs High Risk
| Result | Interpretation | Recommended Next Step |
|---|---|---|
| Low Risk | Low probability of screened conditions in this pregnancy | Continue routine antenatal care. Anomaly scan at 18–20 weeks. |
| Intermediate Risk | Elevated probability — further evaluation recommended | Discuss NIPT or Level 2 USG with your gynaecologist |
| High Risk | High probability of chromosomal abnormality or neural tube defect | Urgent referral for amniocentesis (diagnostic) or Level 2 anomaly scan |
A high-risk Triple Marker result is not a diagnosis. It indicates the statistical probability is elevated and further testing is required. A low-risk result significantly reduces the likelihood but does not eliminate it. Always discuss results with your gynaecologist.
When is the Triple Marker Recommended?
The Triple Marker test is recommended for:
- Women who missed the first trimester Dual Marker window (11–14 weeks)
- Women of Advanced Maternal Age (35 and above)
- Women with a high-risk Dual Marker result needing second trimester correlation
- Women with a family history of neural tube defects or chromosomal conditions
- Women with a previous pregnancy affected by Down Syndrome, Spina Bifida or other conditions
- IVF pregnancies requiring additional prenatal screening
- Women who want to screen for neural tube defects specifically (AFP is the primary screen)
Triple Marker Test Price in Kolkata
Triple Marker Test Price: ₹2,900
No fasting required | USG report & prescription mandatory | 15–20 weeks gestational window (ideal: 16–18 weeks) | Results in 24–48 hours
No fasting required | USG report & prescription mandatory | 15–20 weeks gestational window (ideal: 16–18 weeks) | Results in 24–48 hours
Tests in the Second Trimester Prenatal Pathway
- Triple Marker (15–20 weeks) — this test; second trimester biochemical screen
- Level 2 Anomaly Scan / Targeted Ultrasound (18–20 weeks) — detailed structural survey of all fetal organs; ordered alongside or after Triple Marker
- Fetal Echocardiography — detailed heart scan ordered when triple marker suggests chromosomal risk (heart defects common in Down Syndrome)
- NIPT — can still be ordered alongside or after Triple Marker for higher accuracy non-invasive screening
- Amniocentesis (15–20 weeks) — definitive diagnostic test ordered when Triple Marker is high-risk
- Glucose Challenge Test (GCT) / GTT — gestational diabetes screening typically done at 24–28 weeks alongside second trimester care
Home Collection for Triple Marker Test in Kolkata
Apollo Diagnostics provides home blood sample collection for the Triple Marker test across Nagerbazar, Dum Dum, South Dum Dum and surrounding North and Central Kolkata areas. Please ensure you have your USG report confirming gestational age and your gynaecologist's prescription ready at the time of home collection — these are mandatory for accurate risk calculation.
- Home collection available: 7:00 AM – 2:30 PM Daily
- No fasting required
- USG report and prescription mandatory at time of collection
- Must be within 15–20 weeks gestation (ideal 16–18 weeks)
- Results in 24–48 hours
- Free home collection on orders above ₹2,000
Quick Links
→ Apollo Diagnostics Nagerbazar → Full List of Individual Tests → Book Home Collection → Full Body Checkup Packages
→ Apollo Diagnostics Nagerbazar → Full List of Individual Tests → Book Home Collection → Full Body Checkup Packages
Frequently Asked Questions
Q1. What is the Triple Marker test used for?
The Triple Marker test measures AFP, HCG and uE3 in maternal blood between 15–20 weeks of pregnancy. Combined with maternal age, weight and gestational age it calculates the statistical risk of Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18), open neural tube defects (Spina Bifida, Anencephaly) and abdominal wall defects. It is the standard prenatal screen for women who missed the first trimester Dual Marker window.
Q2. When should the Triple Marker test be done?
The Triple Marker test must be done between 15 and 20 weeks of gestation. The ideal timing is 16–18 weeks for the most accurate AFP values. After 20 weeks the marker levels shift significantly and risk calculation becomes unreliable. If this window is also missed, Level 2 anomaly scan and NIPT (if not yet done) are the remaining options.
Q3. Does the Triple Marker test require fasting?
No. The Triple Marker test does not require fasting. Blood can be collected at any time of day. However you must bring your latest USG report confirming gestational age and your gynaecologist's prescription — both are mandatory for accurate risk calculation.
Q4. What is the Triple Marker test price at Apollo Diagnostics Kolkata?
The Triple Marker test price at Apollo Diagnostics is ₹2,900. No fasting required. Results available in 24–48 hours. Home collection is available free on orders above ₹2,000.
Q5. What does a high AFP in Triple Marker mean?
High AFP (above 2.5 MoM) in the Triple Marker indicates an elevated risk of open neural tube defects such as Spina Bifida (open spine) or Anencephaly (absence of brain development). It can also indicate abdominal wall defects (gastroschisis or omphalocele), multiple pregnancy (twins) or incorrect gestational age. A detailed Level 2 anomaly scan and fetal spine ultrasound are the immediate next steps to visualise the fetal anatomy and identify the source of elevated AFP.
Q6. What does it mean if all three Triple Marker values are low?
When AFP, HCG and uE3 are all low together this pattern is the classic biochemical signature of Edwards Syndrome (Trisomy 18) — a serious chromosomal condition. This pattern should prompt urgent discussion with your gynaecologist for amniocentesis to confirm or exclude Trisomy 18. A detailed anomaly scan is also ordered immediately when this pattern is seen.
Q7. What is the difference between Triple Marker and Dual Marker tests?
The Dual Marker is a first trimester test (11–14 weeks) measuring Free Beta-HCG and PAPP-A, combined with the NT ultrasound scan for about 85–90% Down Syndrome detection. The Triple Marker is a second trimester test (15–20 weeks) measuring AFP, HCG and uE3 with about 70–75% Down Syndrome detection. The Triple Marker additionally screens for neural tube defects (via AFP) which the Dual Marker does not. If possible both should be done — integrated screening gives the highest detection rate.
Q8. Is home collection available for Triple Marker test in Kolkata?
Yes. Apollo Diagnostics provides home blood collection for Triple Marker tests across Nagerbazar, Dum Dum, South Dum Dum, Amarpalli, Motijheel, Kaikhali, Airport Gate 2, Satgachi, Baguiati, Lake Town, Bangur, Sealdah, Entally, Phoolbagan, Tangra and surrounding areas. Please have your USG report and prescription ready. Book by calling or WhatsApping +91 8660434628.
Q9. How long does it take to get Triple Marker test results?
Triple Marker test results are typically available within 24–48 hours of sample collection. Digital reports are delivered to your WhatsApp or email and can be shared directly with your gynaecologist.
Q10. Which centre processes my Triple Marker sample in Kolkata?
All samples collected across North and Central Kolkata are processed at Apollo Diagnostics Nagerbazar — Nandarani Apartment, 8A Narasingha Avenue, Nagerbazar, Dum Dum, Kolkata 700074. Our lab is NABL-certified and ISO-certified.
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