Maternal Screening, Sequential, Specimen #2, Alpha Fetoprotein, hCG, Estriol, and Inhibin A
Ordering Recommendation

Second-trimester screening test for trisomy 21 (Down syndrome), trisomy 18, and open neural tube defects. Requires a previously submitted first-trimester specimen, Maternal Screening, Sequential, Specimen #1, hCG, PAPP-A, NT (3000146). Also requires nuchal translucency measurement performed by an ultrasonographer certified by the Fetal Medicine Foundation (FMF) or Nuchal Translucency Quality Review (NTQR). 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.
Submit With Order
  • The patient information provided with the Sequential, Specimen #1 will be used to calculate the risk
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Specimen must be drawn between 14 weeks, 0 days and 24 weeks, 6 days gestation. The recommended time for maternal serum screening is 16 to 18 weeks gestation. 
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. 
Requires that a previous first trimester specimen, Maternal Screening, Sequential, Specimen #1, hCG, PAPP-A, NT (ARUP test code 3000146), has been performed. 
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.

This test is used to screen for fetal risk of Down syndrome (trisomy 21), trisomy 18, and Open Neural Tube Defect (ONTD, spina bifida).
Hotline History
View Hotline History
Component Test Code*Component Chart NameLOINC
0080021Patient's AFP1834-1
0080267MoM for DIA35738-4
0080268Patient's DIA23883-2
0080918MoM for AFP20450-3
0080920Maternal Screen Interpretation49586-1
0080924Insulin Req Maternal Diabetes44877-9
0080925Family Hx Neural Tube Defect8670-2
0080926Maternal Race21484-1
0080927Number of Fetuses11878-6
0080932Maternal Age At Delivery21612-7
0080941Patient's uE32250-9
0080943MoM for uE320466-9
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
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
3000174EER Maternal Serum, Sequential, Spcm211526-1
3000261Patient's hCG, 2nd Trimester19080-1
3000262hCG MoM, 2nd Trimester20465-1
3000264Maternal Weight29463-7
3000390Gestational Age for Second Specimen18185-9
* 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.
  • Maternal Serum Sequential Screen
  • second trimester screen
  • Sequential Screening
  • Serum Stepwise Sequential Screen
  • Stepwise Maternal Screen
  • Stepwise Sequential, Contingent