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Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [any form], DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from previous biochemical testing)

CPT4 code

Name of the Procedure:

Quad Screen Test (Fetal congenital abnormalities, biochemical assays of four analytes [AFP, uE3, hCG, DIA] utilizing maternal serum, algorithm reported as a risk score)

Summary

The Quad Screen Test is a maternal blood screening that assesses the risk of certain congenital abnormalities in the fetus by measuring four specific substances in the mother’s blood. These substances include alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and inhibin A (DIA). The results are combined with other factors to report a risk score.

Purpose

The Quad Screen Test helps to identify the risk of fetal congenital abnormalities such as Down syndrome, trisomy 18, and neural tube defects. The goal is to provide expecting parents with important information about their baby's health so they can make informed decisions about further testing and care.

Indications

  • Women who are between 15 and 22 weeks of pregnancy.
  • Those who have a family history of birth defects.
  • Older maternal age (usually 35 years or older).
  • Abnormal results from previous pregnancy screenings or tests.

Preparation

  • No special preparation or fasting is required for this blood test.
  • Patients should inform their healthcare provider of any medications they are taking.

Procedure Description

  1. A healthcare provider will draw a blood sample from the mother’s vein.
  2. The blood sample is sent to a lab where it is tested for AFP, uE3, hCG, and inhibin A.
  3. The lab analyzes these results, often in combination with maternal age, weight, ethnicity, and gestational age, to calculate the risk score for certain fetal abnormalities.

Duration

The blood draw itself takes only a few minutes.

Setting

The procedure is usually performed in an outpatient clinic or a healthcare provider's office.

Personnel

  • Blood sample drawn by a nurse or phlebotomist.
  • Lab technologists and genetic counselors may also be involved in analyzing and interpreting the results.

Risks and Complications

  • Minimal risks are associated with the blood draw, including slight pain, bruising, or fainting at the puncture site.
  • False-positive or false-negative results, leading to unnecessary anxiety or a false sense of security.

Benefits

  • Provides valuable information on the risk of congenital abnormalities.
  • Can help parents make informed decisions about further diagnostic testing and management of the pregnancy.

Recovery

  • No recovery time needed; patients can resume normal activities immediately after the blood sample is taken.

Alternatives

  • Other screening tests such as the First Trimester Screening or Non-Invasive Prenatal Testing (NIPT).
  • Comprehensive diagnostic tests like amniocentesis or chorionic villus sampling (CVS), which are more accurate but involve greater risks.

Patient Experience

  • The blood draw might cause slight discomfort.
  • The waiting period for results can be anxiety-inducing.
  • No significant pain management is typically necessary, but patients may receive reassurance and support from healthcare providers.

Medical Policies and Guidelines for Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [any form], DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from previous biochemical testing)

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