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


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

RECALCULATION – call 402-559-5070 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.


  • If the initial specimen was drawn prior to 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 defects but will not 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.

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


  • Perform routine venipuncture and collect a minimum of 2 mls blood in a serum separating tube (SST) 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 our laboratory.
  • Specimens received 7 days or more after collection cannot be accepted because of known degradation of the sample.   



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

PRICING:   Contact the laboratory billing staff for current costs.

TURN-AROUND-TIME:   Results are typically available in 3-4 days.


contact us
Phone:  402-559-5070 
1-800-656-3937 x95070
Fax:  402-559-7248

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