HomePregnancyQuadruple Marker Test in Pregnancy: What is It, Normal and Abnormal Test...

Quadruple Marker Test in Pregnancy: What is It, Normal and Abnormal Test Results, Cost in India


Medically Reviewed By

The World Health Organization (WHO) reports that an estimated 8 million newborns are born with a congenital disability each year. Out of that, around 300,000 babies die due to these associated defects. As morbid as this sounds, this is reality, and a Quadruple marker test in pregnancy helps determine associated complications during gestation.

The quad marker test is very similar to the triple screen and allows the soon-to-be parents to have a detailed understanding of their baby’s health. Your doctor will suggest getting a quad marker test as a must halfway through the pregnancy when the fetus is developing.

This article will explore everything about the quadruple marker test in pregnancy, the test results, and India’s associated cost.

Also Read: Internal OS Closed: What Does It Mean in Pregnancy Scan Report

Get a consultation with the best specialist in your Location

What is the Quadruple Market test in pregnancy?

The quadruple marker test or the quad screen test is done between the 15th and 20th week of pregnancy. It is a type of blood test that determines the increased risks of congenital disabilities in the developing fetus in the womb.

This is primarily a screening test, which offers a fair indication or idea about a handful of risks of congenital disabilities but doesn’t give an assertive diagnosis of a condition. Any drastic differences in the results will push for further testing to rule out any complications.

The quad screening test is completely safe and doesn’t harm the mother or the baby during the procedure.

Also Read: TT Injection in Pregnancy: Why is It Given, in Which Month, Side Effects, and More

When and why does a doctor prescribe the Quadruple Marker test?

Much like the triple screen test, the quadruple marker test is prescribed between 15 and 20 weeks of pregnancy. The OBGYN typically prescribes the test to check the levels of:

Alpha-fetoprotein (AFP)

The liver produces this protein. Abnormally high levels can indicate possibilities of neural tube defects in the baby. It indicates heightened risks of spina bifida or anencephaly in the fetus. Lower levels of AFP indicate heightened risks of Down syndrome. The abnormal levels of AFP also suggest that the mother could be carrying twins.

Also Read: Skincare Products to be avoided during Pregnancy: Sunscreen, Salicylic Acid, and More

Human chorionic gonadotropin (hCG)

The placenta secretes the hCG during pregnancy. Higher hCG levels in the quad marker screen might indicate possibilities of the baby being born with Down syndrome.


The baby and the placenta produce the unconjugated estriol during pregnancy. Low production of this hormone indicates the baby’s risk of having Down syndrome.


The placenta and the ovaries produce this during pregnancy. The heightened levels of this hormone in the bloodstream indicate increased risks of Down syndrome in the developing fetus.

Any drastic differences in the levels of these compounds during the pregnancy can indicate heightened risks of neural tube defects or chromosomal abnormalities in the fetus.

Also Read: Is Vaginal Birth Safe After Cesarean Delivery? New Research Says there is Over 20% Increased Chances of Perineal Tear

What are the normal and abnormal results of the Quad marker screening?

The normal levels of the test markers in the quad marker screening are as follows:

  • AFP – 10-150 ng/mL (15-18 weeks pregnant)
  • hCG – 13,300–254,000 mIU/mL (13–16 weeks) to 4,060–165,400 mIU/mL (17–24 weeks)
  • Estriol – ≤2.50 ng/mL (first trimester) and ≤9.60 ng/mL (second trimester)
  • Inhibin A – 180 pg per milliliter (15 weeks pregnant)

A normal quad marker test will have the average standard levels of these individual markers following the testing. The normal test also indicates that the fetus isn’t prone to heightened risks of being born with uncharted congenital disabilities.

An abnormal quad marker test will call for further testing. If any of the levels are drastically high or low, the doctor can either re-run the quad screening again or suggest further testing for the possible risks about which they are worried.

Who should get the quadruple marker test?

The soon-to-be mother and father always have the last say on which tests they want to do and which ones they don’t. Even if an OBGYN suggests getting the quad marker test, it is the couple’s final decision to undergo the same.

However, the following categories of pregnant women should get a quad marker test without questioning:

  • Pregnant women above the age of 35
  • Pregnant women who suffer from insulin-dependent diabetes
  • Pregnant women with a genetic predisposition or family history of congenital disabilities
  • Pregnant women who have given birth to a baby with congenital disabilities

The quad marker screening is very safe and non-invasive testing. So, it is always a good step to undergo the screening instead of keeping it as an option on the side.

Also Read: Maggi During Pregnancy: Is It Safe for Pregnant Women to Eat, Nutritional Facts

Get a consultation from the best IVF center of your Location

What is the cost of the Quadruple Marker test in India?

The average cost of the quad marker screening in India starts from INR 1600. This is an average price and will vary depending on the state or the city in which you get tested.


The Quadruple marker test is a safe and highly informative screening during pregnancy. Not only does it indicate abnormalities and possible risks in the developing fetus, but it also prepares the mother and the father to take on possible challenges that life could throw at them. Sometimes, it is better to be informed than to be completely clueless.

Somapika Dutta (B.Sc Physiology, Honours)
Somapikar holds Bachelors Degree in Physiology from University of Culcutta. She has 6+ years of experience writing in different niches, including health, tech and lifestyle. An animal enthusiast and a raging foodie, experiencing life - one day at a time.


Please enter your comment!
Please enter your name here

Exclusive content

Latest article

More article