Ordering Recommendation

Second-trimester screening test for trisomy 21 (Down syndrome), trisomy 18, and open neural tube defects.

Mnemonic
MS QUAD
Methodology

Quantitative Chemiluminescent Immunoassay

Performed

Sun-Sat

Reported

2-3 days

New York DOH Approval Status
This test is New York DOH approved.
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.

Collect

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

Refrigerated.

Unacceptable Conditions

Plasma. Hemolyzed specimens.

Remarks

Submit with Order: Patient's date of birth, current weight, due date, dating method (US, LMP), 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.

Stability

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 Category

Laboratory Developed Test (LDT)

Note

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
N/A
CPT Codes

81511

Components
Component Test Code* Component Chart Name LOINC
0080021 Patient's AFP 1834-1
0080241 Estimated Due Date 11778-8
0080267 MoM for DIA 35738-4
0080268 Patient's DIA 23883-2
0080918 MoM for AFP 20450-3
0080920 Maternal Screen Interpretation 49586-1
0080922 Specimen 19151-0
0080923 Dating 21299-3
0080924 Insulin Req Maternal Diabetes 44877-9
0080925 Family Hx Neural Tube Defect 8670-2
0080926 Maternal Race 21484-1
0080927 Number of Fetuses 11878-6
0080932 Maternal Age At Delivery 21612-7
0080941 Patient's uE3 2250-9
0080943 MoM for uE3 20466-9
0081158 Family History of Aneuploidy 32435-0
3000165 Smoking 64234-8
3000171 EER Maternal Serum, Quad 11526-1
3000261 Patient's hCG, 2nd Trimester 19080-1
3000262 hCG MoM, 2nd Trimester 20465-1
3000263 Gestational Age Calculated at Collection 18185-9
3000264 Maternal Weight 29463-7
* 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.
Aliases
  • AFP 4 Marker Screen
  • AFP MS4 (Quad)
  • Alpha Fetoprotein, hCG, Estriol, and Inhibin
  • Maternal Screening, AFP 4 Marker
  • QUAD
  • Quad AFP
  • Quad screening
Maternal Serum Screen, Alpha Fetoprotein, hCG, Estriol, and Inhibin A (Quad)