14 wk blood test - not the scan - says potential growth problem - anyone experience this?

[Heated]

This has not been a trouble-free pg at all and just need to know how common is this to get a bit of perspective and stop me fretting for 7 weeks! How can a blood test show growth problems when the scan last week indicated all was well?

Letter says "one part of your blood test varies slightly from what we would expect" so are going to give me an extended ultrasound scan at 20 weeks.

"The results indicate you baby might have a slightly higher chance of being smaller than average later on in pregnancy"

"The additional test involves looking at the blood flow to your placenta."

Hate the vagueness of it, I like facts, and want to know what does a blood test actually show that a scan can't? And if a blood test is showing this up, does it mean it's potentially more serious?

[allstarsprincess]

Not sure if this will help but could it be:

Hyperviscosity (decreased blood flow due to an increased number of red blood cells) This can sometimes lead to IUGR.

Call them up and ask what they are concerned about. I hate letters like this too!

Good luck.

[Heated]

Thanks for replying and the suggestion, Allstarprincess. If I call them will they actually tell me anything, do you think?

Or maybe I should speak to my MW or GP? Was half minded to anyway as consultant went on about it being important to hear the heart beat for the first time but didn't try because she could feel my bladder was full and uterus tilted.

I have done a search on MN about it, but it's always the scan that shows up the problem and baby's scan was fine, so I do want to know what the bloods are showing.

[angel1976]

I had my blood tested when I had a CVS done with DS1 (he was high risk at 12-week scan for chromosonal defects) and this was a while ago so my memory is a little hazy but my PAPP-A hormone level was a little low/high (can't remember which!) and it could mean fetal growth problems as by then, I already had the CVS and it was all clear for chromosonal defects. Maybe ask them if that is the hormone that is showing the problem? I think the other hormone they test for is the free B-hCG level.

Try not to worry, I had bloody scans all through my first pregnancy because of all these so-called problems and DS1 is now a very healthy and cheeky 23-month-old!

[Owlingate]

Yes its lower PAPP-A levels which may indicate a later problem with blood flow through the placenta. Research in this area is still very vague and new so they can't draw any real conclusions from it. You are being offered doppler scan which shows blood flow through the placenta later, I had one at 18 weeks and 24 weeks. If the doppler shows probs, you will be monitored for IUGR and have further scans etc. Many people with low PAPP-A levels do not have probs with placenta; many babies with a degree of IUGR do not have problems in later life. Ask what your PAPP-A levels were compared to the average, you may find they are only slightly lower.

[Heated]

Thank you so much for this information, it's reassuring to hear from others who have had similar problems and everything has turned out so well. And what you say ties in with what a mw told me this morning when I rang their line.

MW said it's a new test and not to worry, it's not to do with any abnormalities but growth which usually shows ok at 20 weeks but they will do a thorough scan and may scan me later on as well (which they will be doing anyway since I have thyroid problems) - so kind of reassured.

I see my mw in 2 weeks so will ask her about PAPP-A levels then, Owlingate and now at least I go knowing the right question to ask, thank you.

[bearcrumble]

I had low PAPP-A and when I had the uterine artery doppler at 22 weeks that showed a high pulsatility index - both of these things put me at high risk for pre eclampsia and/or IUGR.

Your hospital will keep an eye on you and do more regular scans. My hospital does routine scans for everyone at 12 and at 20 weeks.

I had extra ones at 28 and 30 weeks - growth was a bit slow on the first of these two but had picked up by 30 weeks. I do have high blood pressure now but they knew to check more often for this so I'm glad I had those tests earlier. I'm being treated with beta blockers and I see the consultant weekly.

I think 20 weeks is a bit early for growth problems to start.

I was told my chance of having these problems was 1 in 5. Obviously even if you do get one or the other then you could have them really mildly - it's impossible to tell. But it is reassuring to know that 80% of women with low PAPP-A go on to have no problems at all.

It sucks because you're always worrying about what's going to show up next time but it is better by far to have check-ups so they can do something if things do start to deviate too much from the norm.