Maternal Screening, Sequential, Specimen #1, hCG, PAPP-A, NT
Ordering Recommendation

First-trimester screening test for trisomy 21 (T21, Down syndrome) and trisomy 18 (T18). Requires nuchal translucency measurement performed by an ultrasonographer certified by the Fetal Medicine Foundation (FMF) or the Nuchal Translucency Quality Review (NTQR). Refer to Maternal Screening, Sequential, Specimen #2, Alpha Fetoprotein, hCG, Estriol, and Inhibin A (3000148) for second-trimester screening test for T21, T18, and open neural tube defects. Risks provided in both first and second trimesters.

Quantitative Chemiluminescent Immunoassay
2-4 days
New York DOH Approval Status
This test is New York DOH approved.
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Specimen must be drawn between 11 weeks, 0 days and 13 weeks, 6 days gestation. (Crown-Rump length (CRL) must be between 43-83.9 mm at time of specimen collection.) 
Serum Separator Tube (SST) or Plain Red. 
Specimen Preparation
Separate from cells ASAP or within 2 hours of collection. Transfer 3 mL serum to an ARUP Standard Transport Tube. (Min: 1 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Plasma. Hemolyzed specimens. 
Submit with Order: Patient's date of birth, current weight, number of fetuses present, patient's race, if the patient was diabetic at the time of conception, if there is a known family history of neural tube defects, if the patient has had a previous pregnancy with a trisomy, if the patient is currently smoking, if the patient is taking valproic acid or carbamazepine (Tegretol), if this is a repeat sample, and the age of the egg donor if in vitro fertilization.

In addition to the above: the date of ultrasound, the CRL measurement, the nuchal translucency (NT) measurement and the name and certification number of the sonographer is required.

NT must be measured when the CRL is between 38-83.9 mm.

The NT measurement must also be performed by an ultrasonographer that is certified by one of the following agencies: Fetal Medicine Foundation (FMF) or Nuchal Translucency Quality Review (NTQR). To avoid possible test delays for an ultrasonographer that is new to our database, please contact the genetic counselor at (800) 242-2787 extension 2141 prior to sending specimen.

If an NT is unobtainable, order Maternal Serum Screening, Integrated (ARUP test codes 3000147 (collect in first trimester) and 3000149 (collect in second trimester)), which can be interpreted without an NT value. 
After separation from cells: Ambient: 72 hours; Refrigerated: 2 weeks; Frozen: 1 year (Avoid repeated freeze/thaw cycles.) 
Reference Interval
By report
Interpretive Data
Refer to report.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

The first specimen of a Sequential Maternal Serum Screening is used to measure PAPP-A and hCG. This test is used to screen for fetal risk of Down syndrome (trisomy 21) and trisomy 18. Final interpretative report, which also includes fetal risk for Open Neural Tube Defect (ONTD), will be available when the second specimen test results are complete.
Hotline History
Component Test Code*Component Chart NameLOINC
0080920Maternal Screen Interpretation49586-1
0080926Maternal Race21484-1
0080927Number of Fetuses11878-6
0080932Maternal Age At Delivery21612-7
0081065Nuchal Translucency (NT)12146-7
0081068MoM for PAPP-A32123-2
0081069Sonographer Certification #49089-6
0081070Sonographer Name49088-8
0081071Ultrasound Date34970-4
0081074MoM for NT49035-9
0081158Family History of Aneuploidy32435-0
0081331Best date to draw sample #2 by33882-2
3000163PAPP-A Maternal48407-1
3000166Crown Rump Length11957-8
3000168Nuchal Translucency (NT), Twin B
3000169MoM for NT, Twin B49035-9
3000170Crown Rump Length, Twin B11957-8
3000173EER Maternal Serum, Sequential, Spcm111526-1
3000259Patient's hCG, 1st Trimester19080-1
3000260hCG MoM, 1st Trimester20465-1
3000263Gestational Age Calculated at Collection18185-9
3000264Maternal Weight29463-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • first trimester screen
  • Maternal Serum Sequential Screen
  • Sequential Screening
  • Serum Stepwise Sequential Screen
  • Stepwise Maternal Screen
  • Stepwise Sequential, Contingent