Quad Screen and MS-AFP only

Test name:  Quad Screen & Maternal Serum Alpha-Fetoprotein Only (MS-AFP only)
Also known as: QUAD Fetal Risk Assessment, Maternal Serum Quad Screen, AFP only

Indications: 

• Quad Screen: Any pregnant patient who has not had 1^stTrimester Screening, cell free fetal DNA screening, or amniocentesis.
• MS-AFP only: Any pregnant patient who has had 1^st Trimester Screening or cell free fetal DNA screening. MSAFP is not recommended after amniocentesis.

Test Information: Results interpreted between 14 weeks 0 days and 20 weeks 6 days gestation.
Some literature suggests results are most accurate between 16-18 weeks gestation. If available, 1^st Trimester ultrasound information is preferred to calculate gestational age by CRL.

• Quad Screen: Provides a risk assessment for Down syndrome, Trisomy 18 and open neural tube defects for singleton gestation; for a twin gestation a risk assessment for Down syndrome and open neural tube defects only. Certain patterns of maternal serum markers may also indicate additional concerns for triploidy, Smith-Lemli-Opitz syndrome, Steroid Sulfatase Deficiency, IUFD, ventral wall defects and/or obstetrical complications.
• MS-AFP Only: Provides a risk assessment for neural tube defects and may indicate concern for ventral wall defects and/or obstetrical complications.

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Recalculation – call 402-559-3028 in the following situations:

• If LMP was initially used for dating and ultrasound shows a difference of 9 days or greater, or if incorrect dating was initially provided.
• Initial information provided was incomplete or incorrect regarding pregnancy or family information including but not limited to singleton vs twins, IDDM, relative with a neural tube defect, or prior child with Down syndrome.

Repeat Quad Screen or MS-AFP only:

• If the initial specimen was drawn priorto 14 weeks 0 days OR the initial result was interpreted as a positive/high risk for open spina bifida due to a “borderline elevated level” of AFP. Repeat samples only provide risk assessment for open neural tube deftcts but willnot provide a risk for Down syndrome or Trisomy 18.
• Do not repeat if the initial specimen was “positive” for Down syndrome or Trisomy 18 since this increases the risk for false positives.
• Since AF-AFP is completed with an amniocentesis at HGL, Quad Screen/MS-AFP is not recommended if amniocentesis has been completed in the current pregnancy.

Specimen requirements: 

• Perform routine venipuncture and collect a minimum of 2 mls blood in a red stoppered vacutainer (for either test).
• Allow blood to clot at room temperature. If a centrifuge is available, spin clotted blood and remove serum to a sterile container and ship at room temperature to laboratory.
• Specimens received 7 days or more after collection cannot be accepted because of known degradation of the sample.   

CPT codes: 

• Quad Screen: 82105, 82677, 84702, 86336
• MS-AFP only: 82105

Pricing: Contact the laboratory billing staff for current costs

Shipping & Handling

Required forms: Quad Fetal Risk Screen and Maternal Serum Alpha-Fetoprotein ONLY (MSAFP) Request Form

Turn-around time: Results are typically available in 3-4 days

Additional links: Quad Screen brochure in English, Quad Screen brochure in Spanish 

revised: 5-15-13