<prompt> A 34 years old patient came for antenatal ultrasound in her 2nd trimester. Her beta HCG level is raised, however AFP level is decreased. Patient has one 5 years old child who does not have any chromosomal abnormalities. Most likely diagnosis is?Down syndromePatau syndromeEdward syndromeTrisomy 16  <response>: Quadruple Screening test On mothers serum at 16 weeks of gestation Evaluation Trisomy NTD Omphalocele Gastroschisis Multiple Gestatoin 21 18 13 AFP uE3 NA NA HCG NA NA DIA NA NA Above ultrasound image shows VSD which can be seen in trisomy 21. 