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Test Code H04 Integrated Screen 2nd Trimester

Important Note

This test is run in conjunction with and collected after the Integrated Screen 1st Trimester. Results will not be reported unless both samples have been submitted and received by the State Hygienic Laboratory.


Additional Codes


PowerChart: Integrated Maternal Screen 2nd Trimester

MA Cerner: Integrated Scrn 2nd Trimestr

Specimen Requirement

2 mL of serum is required.

Additional Specimen Collection Information

Stage 1 is collected during first trimester, when crown-rump length (crl) is between 32-80 mm. This measurement is required for screening in the first trimester. The Nucal Translucency measured by a certified sonographer during ultrasound is required for first trimester screening.

  1. Collect blood in a plain, red-top tube(s) or serum gel tube(s).
  2. Allow the blood to clot, then centrifuge and remove serum (at least 2 ml) from the tube and transfer to a tube labeled with patient name or unique identifier and date of birth.
  3. Wrap the tube in absorbent material and place in a biohazard bag.
  4. Roll the specimen in the bag and place in a SHL mailer with an “A”-code self-adhesive  wrapper provided.
  5. Ship at ambient temperature.
  6. Unlabeled specimens will not be tested.
  7. Send along with the completed Iowa Maternal Screen Test Request form.
    SHL Maternal Screening Request Form
  8. The specimen must be received by SHL within 9 days of collection date.

Stage 2 is collected during second trimester; between 15-20 weeks.

Reference Value



The Integrated Screen 2nd Trimester is a screening test for Down’s Syndrome, Trisome 18 and Open Neural Tube Defects. Results of the Integrated Screen 1st Trimester are released after completion of the Integrated Screen 2nd Trimester:

Nucal Translucency (NT), Pregnancy-Associated Plasma Protein-A (PAPP-A), Alpha Feto-Protein (AFP), Estriol, Human Chorionic Donadotropin (HCG) and Inhibin are reported. Also included are the risk assessment for age related Down’s Syndrome, Down’s Syndrome and Trisomy 18. An interpretation and recommended action are also included.

Useful For

Detection of possible fetal abnormalities due to birth defect or chromosome abnormalities


Test performed Monday through Sunday

CPT Code Information

82105 Chemistry: Alpha-fetoprotein (AFP); serum

82677 Chemistry: Estriol

84702 Other and Unlisted Chemistry Tests: Gonadotropin, chorionic (hCG); quantitative

86336 Diagnostic Immunology Testing: Inhibin a

84163 Chemistry: Pregnancy-Associated Plasma Protein-A (PAPPA)

LOINC Code Information

49085-4 First and Second Trimester Integrated Maternal Screen Panel

Test Method

Quantitative Chemiluminescent Immunoassay