What is triple test? How and When to Do It?

Prenatal screening tests include various tests that are applied intermittently to both evaluate the development of the baby and observe the effects of pregnancy on the mother. While mother and baby are systematically evaluated with standard screening tests, various health problems that may arise during pregnancy, birth and the postpartum period are emphasized. Triple screening tests performed during the second trimester of pregnancy are extremely important, especially in order to detect high-risk pregnancies in advance, to detect chromosome-related diseases such as Down syndrome before birth, and to ensure that the birth occurs in the healthiest way for both the mother and the baby.

What is triple test?

Screening tests during pregnancy are applied to determine the risks of different diseases that may occur in the baby. The triple screening test applied in the second trimester of pregnancy primarily enables the detection of high-risk pregnancy and directs the physician to perform a detailed examination. Like all medical tests, the triple screening test is not 100% diagnostic, but only serves as a guide for a more detailed examination of the process.

Although the triple screening test, which was first implemented in the 1980s, was initially used only to detect Down syndrome at an early stage, it is now preferred to detect important chromosomal anomalies such as trisomy 18, trisomy 21, and neural tube defects that can cause serious developmental problems in the baby before birth. . In addition, in line with many recent studies, it is possible to say that the results of the triple screening test are informative about many other health problems related to the baby in addition to genetic diseases. Thanks to this test, which evaluates MS AFP, hCG and unconjugated estriol (uE3) levels, it is possible to detect high-risk pregnancies at an early stage.

Preeclampsia, also known as pregnancy poisoning in society, is one of the serious pregnancy complications that is very common, especially in women over the age of 35, and puts both the life of the mother and the healthy development of the baby at risk. With the sudden increase in the mother’s blood pressure, various organ dysfunctions occur, especially the kidneys. As a result, blood flow to the placenta decreases and serious health problems due to circulatory disorders develop in the baby. In line with the studies conducted on screening tests in recent years, it is possible to say that the risk of this serious pregnancy complication, which can lead to organ loss and even death in the mother, can be detected early thanks to the triple screening test. In addition, evaluation of AFP, hCG and unconjugated estriol (uE3) levels in combination with maternal age may help in the early detection of gestational diabetes mellitus, intrauterine growth restriction (IUGR) in the baby and some such negative pregnancy outcomes.

How to Perform Triple Screening Test?

Pregnancy is a complex process that is extremely complicated for both mother and baby and can lead to various health problems. It is extremely important to pay attention to regular pregnancy checks in order to be able to recognize the problems that may arise during pregnancy and to accurately evaluate the baby’s development. Intrauterine growth restriction (IUGR) seen in the baby may be an indicator of many underlying diseases. For this reason, it is necessary to continue regular physician check-ups and routine screening tests planned from the beginning of pregnancy.

The triple screening test, which is applied during the 3-6 month period called the second trimester, provides information about various genetic diseases seen in the baby. Usually 16-18. For this test performed during the gestational weeks, a blood sample is first taken from the mother and the alpha-fetoprotein (AFP), total beta-human chorionic gonadotropin (hCG) and unconjugated estriol (uE3) values ​​in the blood are measured. These results are then divided by median values ​​according to the week of pregnancy and converted into MoM (Multiple of Median) unit. When evaluating the results obtained, the mother’s age, the week of gestation at which the blood sample was taken and many other criteria are calculated and taken into account specifically for the patient. This triple test, which was initially applied only to detect Down syndrome, is now preferred to detect many genetic diseases in the prenatal period.

When is the Triple Screening Test Done?

Screening tests to detect risky pregnancy can be applied with different methods at different periods of pregnancy. Although the results of the double test performed in the first trimester provide information about many diseases, it is often requested that this test be re-evaluated together with the triple screening test in the future. The triple screening test is among the tests performed in the second trimester of pregnancy and is often applied between the 16th and 18th weeks of pregnancy. In order for the test to give reliable results, it is extremely important to measure the alpha-fetoprotein (AFP), total beta-human chorionic gonadotropin (hCG) and unconjugated estriol (E3) values ​​in the blood at the right time. For this, routine checks should not be interrupted and the test should be performed on the day determined by the physician.

What Does Triple Screen Test Height Mean?

Evaluation of unconjugated estriol (E3), beta-human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) levels measured in the triple screening test alone often leads to misinterpretation of the test. In order to reach a reliable result, these values ​​must be interpreted together with the maternal age, the week of gestation at which the blood sample was taken, and similar determining factors. However, if the triple test results are different from normal, it may indicate an increased risk for some diseases, especially chromosomal anomalies.

High AFP and hCG values ​​and low unconjugated estriol (E3) values ​​are most likely a sign of chromosomal anomaly or neural tube defect. However, despite the high AFP value, there may not be a neural tube defect or chromosomal anomaly, and it can be said that complications such as low birth weight, premature birth complication, intrauterine growth restriction (IUGR), oligohydramnios, fetal distress, gestational hypertension, preeclampsia and fetal/neonatal death are more common in these pregnancies. . In addition, the risk of gestational hypertension increases in pregnant women who are considered chromosomally normal but whose hCG level is high in the blood. Again, close follow-up is recommended for pregnant women with higher than normal hCG levels in terms of premature birth, low birth weight and IUGR. Finally, it should be known that a lower than normal level of unconjugated estriol in the triple screening test is also associated with pregnancy-induced hypertension; While the mother should be closely monitored for preeclampsia, the baby should be monitored for complications such as intrauterine developmental delay and fetal death.

The triple screening test is one of the extremely important pregnancy tests that provides information about chromosomal anomalies such as Down syndrome, trisomy 18 and trisomy 21. Regular pregnancy follow-up is critical in order to follow the baby’s development most accurately and to detect possible genetic problems at an early stage. Many pregnancy problems that affect the health of both the mother and the baby can be easily detected with routine check-ups and standard screening tests. For this, a specialist physician should be consulted from the day the pregnancy is noticed; The entire pregnancy process should be continued under close monitoring in accordance with the doctor’s recommendations. Do not forget to have the triple screening test in order to detect serious health problems that may arise regarding the development of the baby without delay and to keep the healthy pregnancy process under control.