A 34 years old patient came for antenatal ultrasound in her 2nd trimester. Her beta HCG level is raised, however AFP level is decreased. Patient has one 5 years old child who does not have any chromosomal abnormalities. Most likely diagnosis is?

Quadruple Screening test On mother's serum at 16 weeks of gestation Evaluation Trisomy NTD Omphalocele Gastroschisis Multiple Gestatoin 21 18 13 AFP | | | | uE3 | | NA NA HCG | | NA NA DIA | | NA NA Above ultrasound image shows VSD which can be seen in trisomy 21.