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Antenatal tests

Low PAPPA, high HCG at 39 but still low risk?

9 replies

HJBeans · 28/08/2015 16:49

Looking for some advice on interpreting combined test results.

I'm 39 and got through a low risk result for DS (1:449) today. But in looking into what the various things listed actually mean, I'm a bit concerned as my HCG is high (MOM = 2.04) and my PAPPA is a bit low (MOM = 0.8). NT was 1.8mm (MOM = 1.06). Obviously don't know how the algorithm works and was wondering if anyone else did. The report has just enough info to get me curious but not enough to explain why I shouldn't be concerned.

The other question I have is about screening for other anomalies which can be estimated with these tests. I'm in Scotland - do we not test for / report these?

Thanks in advance to anyone with more info.

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HJBeans · 29/08/2015 10:07

Bump. Anyone know about this?

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TheDisillusionedAnarchist · 29/08/2015 16:09

Hi, that is pretty good Papp , mine was 0.328 and it took a lot of convincing to get the hospital to treat it as low. The nt is also excellent. I would imagine those two balanced out the high hcg and the age related risk.

However as someone who was
/is the 1 in 450 if you're worried you could have a harmony test which would give you a close to definitive answer without invasive testing. Alternatively the 20 week scan will pick up more. Dd's anomalies were picked up then.

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KittyandTeal · 29/08/2015 20:46

If second what disillusioned has said. My Papp a was 0.08mom so virtually non existent. I was low risk too. Dd2s anomolies also picked up as 20 weeks scan. Although I had 3 anomaly scans because of my Papp a levels.

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TheDisillusionedAnarchist · 29/08/2015 20:56

Kitty out of interest when was your Papp a done? I've read that in t18 it drops throughout pregnancy so the later you take it the lower it is. Mine was done a week before nuchal so I wonder now if we'd repeated it at nuchal if we'd have picked up the t18. Not that it matters.

Op I noticed you asked about other anomalies that could be picked up with such high hcg and low nuchal you are likely to be very low risk for t18 and t13 which are the other two they test for.

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HJBeans · 29/08/2015 20:58

Thanks both for your responses - it's really useful to have a sense of what's considered low. Sorry you're coping with anomalies and hope all is as well as it can be for both of you.

I've been thinking of the harmony, but not wanting to be over cautious if there was no reason to be. Will keep thinking about it - it's just so much to pay for reassurance. Though I suppose well worth it if it picks things up early.

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HJBeans · 29/08/2015 21:01

Thanks for info on t18 and t13, disillusioned. Good to know. It's a bit off that forums can help me understand the test results I've been sent but no NHS info is available (to my manic Googling, anyway). Thanks again.

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KittyandTeal · 29/08/2015 21:08

I didn't know that Dis. Mine was taken at 12 week scan (can't remember exactly what gestation I was then) but dd2 was measuring 2 days behind already by then (the adjusted the dates but I knew she was measuring behind then)

The guys at kings who saw me at 21 weeks were astounded that she'd lived that long with my Papp a. They think it may have been my very regular exercise and being fit that helped her stick around so long. They thought with my hormone levels (hcg was very low too) dd2 should have not made it to 12 weeks let alone 22. She really wouldn't have lasted much longer. By that point she was almost 3 weeks behind (measured 19+3 when she was born at 22+2)

Yes, like dis says, with the higher hcg T13 and 18 are very unlikely.

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TheDisillusionedAnarchist · 29/08/2015 21:23

Yes dd was 5 days behind at nuchal scan too and I knew my dates (I'd seen the follicle burst on ovulation scan.) the consultant recently conceded my dates are right. I am quite amazed dd has done as well as she has and I can't claim fitness so will thank the aspirin.

Apparently measuring small at 12 weeks is a sign of trisomy, there was a study looking at ivf pregnancies that proved this so it is annoying they insist on dating pregnancies by the 12 week scan and won't consider the lmp/ovulation dates.

Dd currently measures about 3 weeks behind which is good because her lung volumes are about 6 weeks behind. survival is looking very borderline but hopefully Her lungs will grow

Op-sorry to hijack your post, hope you're feeling reassured and you have an easy pregnancy and healthy baby.

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HJBeans · 29/08/2015 21:30

Thanks disillusioned - all best wishes to you and your DD, too.

Did another quick search with the benefit of the knowledge you shared (that it was HCG reading raising the risk) and immediately found exactly the info I was looking for.

If anyone lands here wondering how to interpret the numbers they've been sent, there's great info at: www.wolfson.qmul.ac.uk/service-1/antenatal-screening/screening-tests/calculating-the-risk-of-down-s-syndrome