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The triple test is performed from the 14th to the 20th week (best at 16-18 weeks). It analyzes the level of free estriol (E3), alpha-fetoprotein (AFP) and b-hCG and their compliance with the norms at the current time.

A protein that begins to be secreted in the female body on the fourth or fifth day after fertilization. The level of hCG characterizes the state of the placenta at this stage of pregnancy and its deviation from the norm often indicates a danger threatening the fetus, chromosomal abnormalities, and intrauterine infection.

The level of hCG can decrease with the threat of miscarriage, chronic placental insufficiency and even fetal death.

An increase in the level of this protein is noted with multiple pregnancies, a discrepancy between the real and the established period, with toxicosis, gestosis and diabetes mellitus in the expectant mother, against the background of hormones taken to maintain pregnancy. It is also one of the symptoms of Down syndrome in a child, but only in combination with low levels of AFP and free estriol.

ACE (alpha-fetoprotein) is a protein that is produced by the baby's liver in utero. Determination of the level of ACE in the mother's blood reveals defects in the development of the neural tube, digestive tract, urinary system, a serious delay in fetal development, some diseases of the placenta and a number of chromosomal "errors".

Low AFP is one of the signs of Down syndrome in a child. He may also talk about a low placenta, diabetes or obesity in the mother.

With a high AFP in the fetus, there is a high probability of damage to the nervous system - the spine and the brain. A child with such a pathology can be born paralyzed, with an undeveloped or absent brain. ACE increases with the threat of abortion, Rh-conflict, lack of water, intrauterine fetal death. But with multiple pregnancies, its high high level is the norm.

E3 (free estriol) is a female sex hormone produced by the placenta and the liver of the fetus. It improves blood flow through the vessels of the uterus, stimulates the development of the ducts of the mammary glands during pregnancy.

A sharp decrease in estriol levels indicates a critical condition of the fetus. A decrease in estriol can be a sign of placental insufficiency, delayed physical development or fetal anemia, Rh-conflict, intrauterine infection, malformations of the adrenal glands, central nervous system, heart, and Down's syndrome. But this can also be observed with insufficient nutrition of the mother or when taking antibiotics.

A high level of estriol indicates a large fetus or multiple pregnancy, sometimes liver disease. But a sharp increase in the amount of the hormone in the blood - to the likely premature birth.

But the triple test is called such not only because three indicators are analyzed, but also because all three results should be evaluated only together, changing only one parameter is usually not scary.

It is worth recalling that the triple test is a screening ("screening") study; it is not used to diagnose, but only to determine whether a pregnant woman belongs to a risk group.

It is recommended to start taking tests not at the last moment, so that in case of poor results there is time to retake the test to exclude laboratory errors and random factors. All indicators may differ from the norm in a normal pregnancy. The results are influenced by the age, weight, race, bad habits and diseases of the pregnant woman. Therefore, if the triple test showed the threat of Down syndrome or another terrible disease in the baby, it is necessary to turn to a geneticist who will conduct an in-depth analysis taking into account all individual factors, and also take into account the results of the double test carried out in the first third of pregnancy. It is even possible to use it (i.e., with penetration into the uterus), in which the cells of the baby himself are analyzed for an accurate diagnosis.

Modern medicine is doing everything possible to prevent the development of diseases, however, they arise during pregnancy and it is necessary to correctly assess the consequences. In some cases, you have to use surgical intervention, but it is better to be prepared for this in advance. For such a procedure for predicting risks, there is a triple AFP hCG test DEA-S during pregnancy.

What is a triple test in pregnancy

This is a set of measures and research operations that identify possible pathologies in the baby in the future with a certain percentage probability.

In most cases, this procedure allows you to start therapy at the stage of fetal development. In a short period of time, it is quite easy to affect the central nervous and other systems.

It should be noted that the equipment in all laboratories is different. Therefore, you should not trust tables from the Internet. It is better to use the materials of the same institution where the procedure was carried out.

The test for determining the risk of genetic disorders is called the triple test.

This operation is practiced everywhere. You should not neglect her, since the life of not only the child, but also the woman herself, can really depend on this.

When is it necessary to carry out

Experts advise turning to this method regularly, starting from a period of several weeks.

At the same time, 8 periods are distinguished during which fluctuations occur, according to the state of which the health of the child can be determined.

If there is no such possibility, then you can limit yourself to two or three terms:

1. First trimester.
2. The last one, a week before the scheduled birth.
3. In some cases, it will be useful in the period from 20 to 24 weeks, but at the same time, this is notified in advance.

An important feature is that the disease cannot be diagnosed with 100% accuracy.

With poor results, this can cause the development of:

1. Intrauterine death.
2. Chromosomal pathologies.
3. Early termination of pregnancy.

That is why it is extremely important to monitor indicators and conduct a survey on a regular basis. This will allow you to notice health problems at a stage when they can still theoretically be avoided or at least significantly reduce the damage.

What does it consist of

In essence, if we set aside the complex terminology, then the girl will have a regular blood test and.

The blood test should be done on an empty stomach.

The only significant difference with other surveys is that narrow spectrum information is analyzed. It only deals with three elements. At the same time, there is no need to doubt the necessity and correctness of the procedure.

It must be carried out by every woman in a position during the second trimester.

What congenital defects can be found

During the tests, when the results are known, doctors can diagnose a huge number of diseases. Some of which lead to death or serious congenital abnormalities.

The reason for a positive result can be:

1. Multiple pregnancies.
2. Large size of the child, above the norm. Subject to this point, it is recommended to carry out an analysis for in the body. The probability for this factor is quite high.
3. Down syndrome or other mental and physical developmental disabilities caused by changes in chromosomes or DNA.
4. High chance of miscarriage or death. In this case, there is a need for urgent medical intervention. So that they make the right decision and begin the rehabilitation period to reduce the risks.
5. The possibility of the formation of organs outside the baby's body.

It is worth noting that the result of a triple test cannot be a medical reason for termination (abortion). To do this, it is necessary to carry out and already on the basis of his conclusion, the doctors will directly make a decision.

Indications for conducting in the II trimester

The expectant mother has the right to refuse research, but it is highly discouraged to do so.

Based on the data, special risk groups are compiled, which mostly include:

The data are compiled in such a way that when the above points are fulfilled, the risk of congenital pathologies in a child is significantly higher than in completely healthy people.

The need for a triple test in the second trimester increases significantly with appropriate smears.

Dad pregnancy test what is it

A procedure that is performed in each trimester. Aimed at checking the cellular state of the maternity organs.

Why make up a risk group

Despite popular beliefs, doctors care about the health of citizens. It is much easier to do this if you notice the development of the disease in time and start treating it.

In this case, there will be no need for a hospital and there will be no need to carry out expensive surgical operations.

To avoid being included in the list due to an error, there are certain rules that must be followed.

How to take a pregnancy test

To begin with, it is worth taking care of the special necessary diet, if there is one in the prescription.

Moreover, if the examination takes place in the morning, it is advisable not to eat anything, or to provide yourself with a light breakfast.

Norms

There are certain values ​​that indicate that the body is completely healthy.

In this case, sometimes some error and permissible excess / decrease are noted.

HCG subunits

Free hCG is normally 5 millimeters per liter, and there is no need to worry when the readings fluctuate. Since during the entire pregnancy this happens often and is an absolute norm.

A-fetoprotein

The AFP rate by week can be presented in the form of a table:

Free esyrol (DEA-C)

In the early stages, it reaches 0.7-2.5 nanomoles per liter, at the last about 35-120 nanomoles. At the same time, there is a trend due to which the indicators are constantly growing. In about two weeks, they should increase by at least 2-3 moles.

If this does not happen, then this indicates the development of pathology.

There is a likelihood of such an outcome in both the mother and the child, because the trace element is secreted by both organisms.

Explanation of abbreviations

For the convenience of data processing, scientists use special abbreviations that are difficult to decipher for an unknowing person.

The triple test measures three important indicators at once:

In fact, the triple detailed test that every pregnant woman must take in the second trimester (between 16 and 20 weeks) is a fasting morning blood test and an ultrasound scan. One could say that it is ordinary, but its results are so important and significant, they can soothe the expectant mother and save her from possible sleepless nights that it would be more correct to classify this type of analysis as paramount. Even if the triple test carries a screening (screening) value and not a diagnostic one.

Testing three metrics

By means of a triple test, two types of protein (chorionic gonadotropin CG and alpha-fetoprotein AFP) and sex hormone (free estriol E3) are analyzed.

These three components are investigated together for the reason that only deviation from the norm of all three indicators together is considered critical; a change in one danger does not conceal.

In the early stages, this analysis allows you to detect possible pathologies in the fetus, namely: Down and Edwards syndromes and a neural tube defect.

The triple test does not pose a threat to the life and health of the child and mother. Moreover, expectant mothers reveal an acute desire to go through it and once again make sure that everything is in order with the baby.

Terminology and its interpretation

Usually, after a triple examination, a pregnant woman is given a table with medical terms and columns of numbers on her hands, which the patient cannot figure out on her own (unless she has special education). A busy doctor can only briefly state that everything is in order, do not worry, or, if everything is not in order, make an appointment with a geneticist.

To help a pregnant woman so that she can navigate at least a little in the indicators and designations, we will dwell on them more specifically.

HCG is the herald protein. It begins to be secreted in a woman's body as early as 3-5 days after conception; it is he who signals you about pregnancy when you use a test bought at a pharmacy; it is he who "informs" about the state of the placenta, and these deviations from the norm warn of the dangers that threaten the fetus.

A low level of hCG indicates chronic placental insufficiency and the threat of miscarriage.

A high level of hCG is noted with multiple pregnancies, with toxicosis, a discrepancy between the real and the established gestational age. HCG can increase with certain diseases of the mother (diabetes mellitus) or due to the woman taking hormonal drugs.

ACE is your baby's protein product. Alpha-fetoprotein is produced by the fetal liver. Determination of the ACE level helps in identifying defects in the neural tube of the child, the genitourinary and digestive systems.

Increases with oligohydramnios, Rh-conflict. High ROS levels are not cause for alarm if you carry twins or triplets.

A low ROS level indicates a low location of the placenta, diabetes or obesity in the mother. To diagnose Down syndrome in a fetus, this indicator alone is not enough. Low ACE and E3, but high hCG - this is a real cause for alarm. But such a coincidence is rare.

E3 is a female sex hormone produced by the placenta and not without the participation of the fetus. Thanks to him, the ducts of the mammary glands are stimulated, preparations for lactation are in full swing and the blood flow in the mother's body is activated.

A high level of estriol indicates the size of the fetus or even more than one fetus, less often - liver disease.

Low estriol is not a good indicator. Indicates either intrauterine infection, or placental insufficiency, or Rh-conflict, or malformations of the baby (adrenal glands, nervous system, heart). In addition, a decrease is possible when the mother is undernourished or when she is using antibiotics.

Triple test, or "prenatal risk assessment": hCG, AFP and free estriol

The main purpose of blood tests during pregnancy is determination of the risk of pathologies in the fetus... "Triple test" is a blood test of a pregnant woman for the level of hCG, AFP and free estriol. The test is carried out between, in the morning, strictly on an empty stomach... The doctor in the antenatal clinic is obliged to send the expectant mother to this study. A special program calculates the risk of having a baby with Down's disease, the risk of DZST (this abbreviation denotes certain groups of congenital malformations) and the risk of fetal growth retardation. As a result, you are given a result where incomprehensible numbers and letters are written.

So, let's figure out what all these abbreviations, numbers, letters mean and what is their meaning for us.

• HCG is a human chorionic gonadotropin, it begins to be secreted in a woman's body immediately after the embryo is attached to the wall of the uterus (this happens about the fourth to fifth day after fertilization). HCG is a protein of the placenta, the level of which characterizes the state of the placenta at a particular stage of pregnancy; it can change if the fetus (and, accordingly, in the placenta) has chromosomal abnormalities. Protein levels can also reflect the presence of a threat of termination of pregnancy, changes in the placenta due to infection, immunological conflict and other reasons. An altered level of hCG can be observed during a normal pregnancy (!).

If hCG is low (for the norms of the hCG level for each term, see below), this may indicate a threat of termination (if the level of the hormone decreases progressively, by more than 50% of the norm), chronic placental insufficiency, prolonged pregnancy, as well as antenatal fetal death.
If hCG is high, this may indicate multiple pregnancies (the level of the indicator increases in proportion to the number of fetuses), prolonged pregnancy, the discrepancy between the real and the established gestational age, toxicosis, preeclampsia, diabetes mellitus in the mother, and the intake of synthetic gestagens (hormones that contribute to the normal course of pregnancy). High hCG may also indicate the presence of Down syndrome in the fetus, but only in combination with reduced levels of AFP and free estriol!

• AFP - stands for alpha-fetoprotein. It is a protein product that is produced by the baby's liver and enters the mother's bloodstream during pregnancy. Determination of its level is used to exclude the development in the fetus of neural tube defects, various parts of the digestive tract, urinary system, as well as Shershevsky-Turner syndrome (an incurable chromosomal disease characterized by congenital defects of the heart and other internal organs, infertility; sometimes - a decrease in mental development), severe fetal growth retardation, certain diseases of the placenta and, finally, Down's syndrome.

Low AFP (see below for the normal level for each term) occurs with Down syndrome in the fetus, with a low placenta, obesity, the presence of diabetes mellitus, hypothyroidism and some other diseases in a pregnant woman, as well as with normal pregnancy (!). There are also racial and AFP levels.
If AFP is high, this may mean that the child may have damage to the nervous system: softening of the spine, the absence of the whole brain or its parts. With such a pathology, a child can be born with paralysis of the lower half of the body and anencephaly (a disease in which the child's brain is seriously underdeveloped or does not develop at all). Also, an increased level of AFP is observed with an unfavorable course of pregnancy, the threat of termination, Rh-conflict, oligohydramnios, intrauterine fetal death. An increased level of AFP in multiple pregnancies is a physiological norm.

• E3 or free estriol is a female sex hormone that is produced by the placenta and the liver of the fetus. With the course of pregnancy, the level of estriol in the woman's blood gradually increases. Estriol improves blood flow through the vessels of the uterus, promotes the development of breast ducts during pregnancy. A decrease or a sharp decrease in estriol (by 40% or more) indicates a pathological state of the fetus.

Low estriol levels may indicate a threat of miscarriage or premature birth, prolongation, fetoplacental insufficiency, fetal malnutrition (delayed physical growth of the fetus), Rh-conflict, fetal anemia (decreased hemoglobin), intrauterine infection, adrenal hypoplasia, fetal anencephaly (malformations CNS), heart defects, as well as Down syndrome. Also, a low level of free estriol can be observed in the expectant mother with insufficient nutrition, as well as when taking antibiotics.
If estriol is high, this most often speaks of a large fetus or multiple pregnancy, it can also speak of liver diseases, and only with a sharp (!) rise in the hormone - about the likelihood of premature birth.
The content of serum markers in the blood of pregnant women varies in accordance with the gestational age; each laboratory uses its own standards depending on the type of reagents used. When evaluating the results, you need to rely only on the standards of the laboratory where the analysis was performed !!! For convenience in assessing the level of serum markers, the values ​​are usually expressed in relative units - MoM (multiples of median - a multiple of the mean). The norm in MoM for any serum marker at any stage of pregnancy is 0.5-2.0 MoM.

Changing only one of the indicators of the "triple test" is not significant, a comprehensive analysis is always required. A correct assessment of the result can be obtained using computer programs for calculating genetic risk, which take into account the individual indicators of each patient - age, weight, ethnicity, the presence of certain diseases, ultrasound data. And even the results of computer calculations do not serve as a diagnosis of the disease, but only represent a statistical assessment of individual risk.

Below is the indicative rate of hCG, AFP and E3. But, as mentioned above, laboratories use different units of measurement, and indicators of the norm are often indicated next to the result.

The normal level of hCG in the serum of pregnant women can be determined from the following table:

Gestational age (weeks)	Median (average value)	Norm
1-2	150	50-300
3-4	2000	1500-5000
4-5	20000	10000-30000
5-6	50000	20000-100000
6-7	100000	50000-200000
7-8	70000	20000-200000
8-9	65000	20000-100000
9-10	60000	20000-95000
10-11	55000	20000-95000
11-12	45000	20000-90000
13-14	35000	15000-60000
15-25	22000	10000-35000
26-37	28000	10000-60000

The content of estriol (E3) in the blood of pregnant women:

Week of pregnancy	Estriol concentration (nmol / l)
12	1,05-3,5
13	1,05-3,85
14	1,4-5,6
15	3,5-15,4
16	4,9-22,75
17	5,25-23,1
18	5,6-29,75
19	6,65-38,5
20	7,35-45,5

The content of alpha-fetoprotein (AFP) in the blood of pregnant women:

Week of pregnancy	Average value (median) IU / ml
14	26,0
15	30,2
16	34,4
17	39,0
18	44,2
19	50,2
20	57,0

The triple test is physically safe for both the mother and the fetus. The only danger is unnecessary worries and worries. The main disadvantage of the study is its inaccuracy, to put it mildly. Now experts say about 80% of false positive results (according to the official version, 5%). For example, a false-positive result is quite possible with an incorrectly defined gestational age, deviations in the mother's weight, and the mother's diabetes mellitus.
Only your personal doctor can evaluate the test results.: only he can see all the nuances of the test! So, in order for the doctor to suspect a genetic pathology in the fetus, it is necessary that the indicators of the triple test be several times higher or lower than the norm, but insignificant changes in the indicators, as a rule, are the reason for re-taking the analysis.
Dear future mothers! Remember one simple thing: you cannot accurately diagnose with this test! It only allows you to identify pregnant women who are at risk, who need to undergo a serious additional examination! Therefore, if the triple test is positive, do not despair and do not jump to conclusions!

Photobank Lori

The triple test is performed from the 14th to the 20th week (best at 16-18 weeks). It analyzes the level of free estriol (E3), alpha-fetoprotein (AFP) and b-hCG and their compliance with the norms at the current time.

A protein that begins to be secreted in the female body on the fourth or fifth day after fertilization. The level of hCG characterizes the state of the placenta at this stage of pregnancy and its deviation from the norm often indicates a danger threatening the fetus, chromosomal abnormalities, and intrauterine infection.

The level of hCG can decrease with the threat of miscarriage, chronic placental insufficiency and even fetal death.

An increase in the level of this protein is noted with multiple pregnancies, a discrepancy between the real and the established period, with toxicosis, gestosis and diabetes mellitus in the expectant mother, against the background of hormones taken to maintain pregnancy. It is also one of the symptoms of Down syndrome in a child, but only in combination with low levels of AFP and free estriol.

ACE (alpha-fetoprotein) is a protein that is produced by the baby's liver in utero. Determination of the level of ACE in the mother's blood reveals defects in the development of the neural tube, digestive tract, urinary system, a serious delay in fetal development, some diseases of the placenta and a number of chromosomal "errors".

Low AFP is one of the signs of Down syndrome in a child. He may also talk about a low placenta, diabetes or obesity in the mother.

With a high AFP in the fetus, there is a high probability of damage to the nervous system - the spine and the brain. A child with such a pathology can be born paralyzed, with an undeveloped or absent brain. ACE increases with the threat of abortion, Rh-conflict, lack of water, intrauterine fetal death. But with multiple pregnancies, its high high level is the norm.

E3 (free estriol) is a female sex hormone produced by the placenta and the liver of the fetus. It improves blood flow through the vessels of the uterus, stimulates the development of the ducts of the mammary glands during pregnancy.

A sharp decrease in estriol levels indicates a critical condition of the fetus. A decrease in estriol can be a sign of placental insufficiency, delayed physical development or fetal anemia, Rh-conflict, intrauterine infection, malformations of the adrenal glands, central nervous system, heart, and Down's syndrome. But this can also be observed with insufficient nutrition of the mother or when taking antibiotics.

A high level of estriol indicates a large fetus or multiple pregnancy, sometimes liver disease. But a sharp increase in the amount of the hormone in the blood - to the likely premature birth.

But the triple test is called such not only because three indicators are analyzed, but also because all three results should be evaluated only together, changing only one parameter is usually not scary.

It is worth recalling that the triple test is a screening ("screening") study; it is not used to diagnose, but only to determine whether a pregnant woman belongs to a risk group.

It is recommended to start taking tests not at the last moment, so that in case of poor results there is time to retake the test to exclude laboratory errors and random factors. All indicators may differ from the norm in a normal pregnancy. The results are influenced by the age, weight, race, bad habits and diseases of the pregnant woman. Therefore, if the triple test showed the threat of Down syndrome or another terrible disease in the baby, it is necessary to turn to a geneticist who will conduct an in-depth analysis taking into account all individual factors, and also take into account the results of the double test carried out in the first third of pregnancy. It is even possible to use it (i.e., with penetration into the uterus), in which the cells of the baby himself are analyzed for an accurate diagnosis.