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Gynaecology & Obstetrics General 980db915

Tripple screening test for Down syndrome during pregnancy includes all of the following except:

A
Maternal serum AFP
B
Serum beta-HCG
C
Alkanline Phosphatase
D
Serum oestriol
High-Yield Explanation
Ans. C: Alkanline Phosphatase The triple test/ triple screen/Kettering test/ Ba's test is an investigation performed during pregnancy in the second trimester to classify a patient as either high-risk or low-risk for chromosomal abnormalities (and neural tube defects). The term "multiple-marker screening test" is sometimes used instead. This term can encompass the "double test" and "quadruple test". A positive test means having a high risk of chromosomal abnormalities (and neural tube defects), and such patients are then referred for more sensitive and specific procedures to receive a definitive diagnosis, mostly invasive procedures like amniocentesis. The Triple test measures serum levels: Alpha-fetoprotein is made in the yolk sac and in the fetal liver, and some amount of AFP gets into the mother's blood. In neural tube defects, the skin of the fetus is not intact and so larger amount of AFP is measured in the mother's blood. In Down syndrome, the AFP is decreased in the mother's blood, presumably because the yolk sac and fetus are smaller than usual. Estriol is a hormone produced by the placenta, using ingredients made by the fetal liver and adrenal gland. Estriol is decreased in the Down syndrome pregnancy. Human chorionic gonadotropin hormone is produced by the placenta, and is used to test for the presence of pregnancy. A specific smaller pa of the hormone, called the beta subunit, is increased in Down syndrome pregnancies.

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