Triple Test: Optional during pregnancy

In the triple test, the blood of the expectant mother is examined between the 15th and 20th week of pregnancy. The risk of a chromosomal disorder is determined by determining three hormones. However, the triple test has become rare, as it can unfortunately often lead to uncertainty in pregnant women due to false positive results.

What is the triple test?

The triple test is another optional screening test in the 15th to 20th week of pregnancy, which examines your baby for possible chromosomal disorders such as trisonomy 21 and trisonomy 18, or is used to rule out an open spine (spina bifida). However, unlike a diagnostic test, it can only estimate a probability. Due to its rather uncertain statements, the triple test is only rarely carried out today and has been almost completely replaced by the nuchal translucency measurement . It is still used in exceptional cases, for example when it is not possible to carry out a nuchal translucency measurement. For the triple test, blood is taken from you to determine the following three hormones.

The triple test examines the following hormones:

  • Alpha-Fetoprotein (AFP): Manufactured in your baby’s liver and excreted into the amniotic fluid through their kidneys. This makes it detectable in your blood. If your child is possibly suffering from a neural tube defect (spina bifida), then the AF value is increased. If the AF value is reduced, there may be a chromosomal disorder.
  • Free estriol (E3): The precursors of estriol are formed by your baby’s adrenal glands and liver. In the placenta, the substances are converted into estriol. Estriol is detectable in your blood and accumulates over the course of your pregnancy. Estriol levels are reduced when your baby suffers from a possible chromosomal disorder.
  • Beta-chorionic gonadotropin (beta-hCG): Forms in your body a few days after the ovum is fertilized. If the value increases, your baby may suffer from Down syndrome. However, if the value is reduced, it may be suffering from Edwards syndrome.

You always have to remember that the triple test is an individual risk assessment. He cannot give you 100% certainty. Therefore, these values ​​are often combined with the nuchal translucency measurement for a more precise determination of the statistical risk of a chromosomal disorder. Your gynecologist can use your age, your weight and the duration of the pregnancy, as well as the results of the blood tests and the nuchal translucency measurement, to calculate the risk of a chromoma change in your baby.

Triple test often leads to uncertainty

With the increased use of nuchal translucency measurement, the triple test has become less important. Unfortunately, it often leads to unnecessary uncertainty in pregnant women and is therefore not used routinely. The triple test is only used in exceptional cases, for example to clarify an open back or when a nuchal translucency measurement is not possible. The test can sometimes give false-positive results. This means that although the test shows that your child has an increased risk of trisomy 21, there is actually nothing wrong with it. False-negative test results are also possible. The triple test indicates that your child is completely healthy, but actually there is an increased risk of a genetic defect. But how can an incorrect test result be generated? You can find some causes in our list:

  • In the case of a multiple pregnancy, all three values ​​are increased
  • The hCG value is increased in smokers or vegetarians
  • There is an incorrect calculation of the duration of pregnancy
  • The baby’s growth is disturbed
  • You suffer from preeclampsia (gestosis)
  • You suffer from kidney disease
  • Due to diabetes you are regularly treated with insulin
  • you are overweight
  • Your placenta is dysfunctional

Triple test not part of normal prenatal care

The triple test is not part of the routine examinations as part of prenatal care . However, your doctor will be happy to inform you about all possible non-invasive and invasive examination methods. You can then decide whether you want to use them or not. Find out more about all examination methods in our “ Prenatal Diagnostics ” section.

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