Fetal cells in the fluid are also examined for Down syndrome, trisomy 18, and other chromosomal abnormalities. Counseling and further information are also available to any woman with an abnormal test result.

Does a normal Triple Screen guarantee a healthy baby?
No. The Triple Screen cannot detect all birth defects. It does not detect all neural tube defects or all chromosomal abnormalities. It can only alert the physician that a pregnancy is at an increased risk for certain problems and that further specialized testing should be considered. Reviewing the family medical history with the physician can also help identify problems that may be detected by other specialized testing.

AFP/HCG/UE3 Prenatal Testing

Genetic Screening & Case Management
Bureau of Children’s Health Texas Department of Health 1100 West 49th Street Austin, Texas 78756-3199 (512) 458-7284

The amounts of AFP, HCG, and UE3 in a woman’s blood during pregnancy can be measured with laboratory tests. The levels change from week to week, so accurate test results depend upon knowing when the pregnancy began.

What do the test results show?
The Triple Screen result will tell a woman whether she has an increased risk for carrying a baby with Down syndrome, trisomy 18 (a chromosome abnormality), or a neural tube defect (spina bifida). About 5% of women will have abnormal levels of AFP, HCG and UE3 in their blood. There are various reasons for the abnormal levels: • The date the pregnancy began may be miscalculated. Determining the correct date of conception is vital to correct test results. For example, normal AFP, HCG, and UE3 levels at19 weeks are abnormal at 15 weeks. • The woman may be carrying twins. Two babies produce more AFP, HCG, and UE3 than one does. • In a few cases with elevated AFP, the baby may have a potentially serious birth defect. The Triple Screen can detect 85% of neural tube defects and abdominal wall defects. Spina

bifida, which affects the spine, and anencephaly, which affects the brain, are neural tube defects. • Low levels of AFP and UE3 and high levels of HCG in maternal blood can indicate that the baby may have Down syndrome, a common chromosomal abnormality. The Triple Screen test can identify about 65% of developing babies with Down syndrome. • Low levels of AFP, HCG and UE3 indicate an increased risk for trisomy 18, a chromosomal abnormality that causes mental retardation and severe birth defects.

What if the result is abnormal?
Remember, the Triple Screen is only a screening test. An abnormal test result simply shows a need to look more closely at the pregnancy. Diagnostic procedures such as ultrasound or amniocentesis may be considered in the event of an abnormal Triple Screen result. An ultrasound study (sonogram) uses sound waves to create a picture of the developing baby. These ultrasound pictures can reveal the presence of more than one baby and the date the pregnancy began. It can sometimes detect structural birth defects. If the ultrasound study shows twins or a miscalculated delivery date, no further testing may be necessary. If an ultrasound study does not provide a reason for the abnormal AFP/HCG/UE3 levels a procedure called amniocentesis may be suggested. Amniocentesis involves sampling a small amount of the fluid surrounding the fetus. This fluid is then tested for its AFP

Every expectant mother wants to have a healthy baby—free of any significant birth defects.

Who should have a Triple Screen?
All women who are between 15 and 20 weeks pregnant can choose to have a Triple Screen. This simple blood test can provide special medical information about the health of the developing baby.

What is the Triple Screen?
The Triple Screen test measures the amount of alpha fetoprotein (AFP), human chorionic gonadotrophin (HCG) and unconjugated estriol (UE3) in a woman’s blood. These are normal chemicals produced by the developing baby or the placenta.
If you are interested in this screening test and it has been no more than 20 weeks since your last menstrual period, ask your doctor for information about receiving a Triple Screen blood test.

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