The goal of every obstetrician should be to give the best prenatal care to the fetus to achieve optimal perinatal outcome. The early assessment of patient specific risks of pregnancy complication has the purpose to improve pregnancy outcome. The first trimester and second trimester Screening tests have high predictive value for adverse pregnancy outcomes. Women should be adequately counseled for the disorders to be screened. Estimation of serum markers has vital role in counselling women and consideration of increased fetal surveillance. With innovations like serum markers obstetricians have the opportunity to improve pregnancy outcomes with effective treatment.