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Very low Papp-a levels

(103 Posts)
KittyandTeal Mon 24-Nov-14 13:01:09

Just wondering if anyone has any information on this.

Had the triple test for DS a week ago. My risk has come back as 1:1700 so very low. However, my Papp a level was 0.08!!! Seems to be very very low.

The only info they've given me is that it could be linked to small babies. I've got additional scans at 28 and 34 weeks. I just don't know how much I need to worry about all this

Mslad Mon 24-Nov-14 13:25:45

Hi Kitty,

I don't have any advice, but I also have very low Papp-A levels. It resulted in a high risk DS result. I've had the harmony test and got the all clear, which is really great, but I'm still very confused about what low papp-a means. I have a midwife appointment this week, where I'll try to find more information, but I'd be interested to hear if anyone else has any info.

Hope your pregnancy is going well otherwise.

Fissawissa Mon 24-Nov-14 13:32:18

I had low papp- a levels, my risk came back at 1:209.
I was told it could resilt in a small baby so was offered growth scans.
Cut a long story short DS is now 5 weeks old and was 10lb 6oz at birth!

KittyandTeal Mon 24-Nov-14 13:46:57

That's what seems odd to me. All the info I can get seems to link it to a high risk of DS. Mine seems to be pretty low.

It's good to know that you've had a big baby.

The ironic thing is because my dd was big(ish) and got stuck so far this pregnancy they've been concerned about this one being big and having a problem getting stuck!

Mslad Mon 24-Nov-14 14:03:24

At my harmony test, the doctor asked about family history of small birth weights and preeclampsia, as they can be related to low papp-a; so I'm going to ask my midwife about both of those. I would like to get extra growth scans just in case, so hope they don't fob me off.

KittyandTeal Mon 24-Nov-14 14:29:22

Ah, my mum was put on bed rest with my brother as he was measuring small (he was her second baby too)

They've offered me extra scans which I'll take. I don't need to worry about harmony tests or anything do I? I've not come back with high risk of DS or other chromosomal issues.

Mslad Mon 24-Nov-14 14:50:04

No you definitely don't need to worry about harmony tests. Your results are very low risk, and I kinda felt I was put through extra worry unnecessarily as my detailed scan was so good. My doctor also said that low papp-a can often just be 'one of those things'. I reckon it will all be fine, but extra scans will probably be good for our peace of mind.

laurenamium Mon 24-Nov-14 15:46:28

I have low PAPP-A and came back low risk for downs. They have put me on aspirin to thin my blood to get more to my placenta and I have scans every 2 weeks after my 20 week scan and meetings with a consultant after each one... Don't google! I did and was a mess as people only seem to post the worst!

If you have any questions at all or any worries ring your midwife and get an extra appointment, mine was shocked that I had been told over the phone and so had no information along side the news. Feel free to PM me if you have any questions smile I'm 18+2 now

KittyandTeal Mon 24-Nov-14 16:17:40

I've just had a letter. No other information. Maybe I should call the midwives.

When did they put you on aspirin if you don't mind me asking. I'm 13+5 and not seeing a midwife until 16 weeks.

Oddly I've got an obstetricians appointment the week after my 20week scan to discuss birth options etc as my first got stick during labour.

Snaveanator Mon 24-Nov-14 16:41:50

Hey!

It just means there's an increased risk of a small baby. I have low PAPP A Too so have been booked in for the additional scans at 28 and 34 weeks. They may show that the babies growth is behind schedule and monitor the situation and decide whether to deliver early. It's very unlikely though. My midwife told me that they've recently changed the formula for this test so a lot more women are now showing as having low PAPP A and more than likely there's nothing wrong with them! Chin up and stay the heck away from Google! Xx

KittyandTeal Mon 24-Nov-14 16:48:40

That's good news smile

I guess I'm just worried as it seems stupidly low at 0.08!

There seem to be lots of stories of people having amnios etc to rule out other issues but I'm guessing if there were any other possible issues other than growth they'd have called.

Thanks, that's made me feel a bit better

laurenamium Mon 24-Nov-14 16:49:09

I got put on aspirin at my 16 week midwife appointment smile she is very thorough though and Was concerned I haven't put on any weight at all during the pregnancy, I do have a huge bump though I've just lost it elsewhere!

strawberry1202 Mon 24-Nov-14 17:19:32

I've also got a low papp a result and so was offered extra growth scans at 24, 28, 32 and 36 week. After some intensive grilling of our consultant on the topic it seems like low papp a is not very "diagnostic" ie it can mean a small baby, but it can also mean nothing at all. Fwiw I've now had the 24 and 28 wk scans and if anything the baby is big for its stage, so I'm trying not to worry. That's not to say I didn't have a minor meltdown when first told about it by a receptionist who seemed to know as little as I did!

SilverStars Mon 24-Nov-14 17:33:53

I have very low Papp-a ( below 0.25) and a higher HCG so I am high risk for DS. The private consultant I saw said I need 3 more scans later on but not yet seen my NHS consultant so not sure if will get them. Private consultant said 10% of people with low Papp-a have smaller babies/placenta issues.

KittyandTeal Mon 24-Nov-14 19:26:01

Well I spoke to the midwife and I'm the talk of the antenatal team apparently. They can't work out why all my other measurements would be fine but my Papp level soooo low.

I called for reassurance and said I'd been reading stuff saying it's linked to miscarriage, premature birth and still birth. She was lovely but said she couldn't really tell me either way if any of that is likely to happen.

My DH is an optimist, he's assuming all is ok until we're told otherwise. I'm kind of the other way and am assuming the worst and that there is now a possibility this pregnancy might not make it.

It looks like I'll have quite a few consultant appointments. She's calling back on weds to let me know if they're going to move my anomaly scan forward or give me an earlier consultant appointment. I'm just hoping this is all something of nothing rather than something to worry about.

I've read lots of positive stories of low levels and big babies but their levels didn't seem to be as low as mine!

laurenamium Mon 24-Nov-14 21:28:35

Kitty you and your DH sound exactly like me and DP, our stories up til now sound very similar too! My mum managed to talk me down by explaining it in that lots of consultant appointments and scans means that they can keep an extra close eye on us and can see if something's going wrong and catch it in time. I have scans every fortnight and the normal midwife appointments in between. The midwife said too that even if everything was fine they would induce me on my due date and I absolutely won't be allowed to go over. It's reassuring that they're being so careful in a way! Or I'm trying to look at it that way!

KittyandTeal Tue 25-Nov-14 07:19:52

Laure

It's good to fine someone with a similar story (kind of anyway, not good you're going through it)

Can I ask how far along you are? Maybe I should be requesting scans every 2 weeks. It's good that it's been picked up and will be monitored, I know in some trusts they don't give you extra scans.

Ironically they weren't going to let me go more than a few days over anyway due to my dd birth! I may be entitled to a elcs which I was thinking if turn down but now it seems like a better idea.

I guess I'm twitchy because there do to seem to be any solid answers and that always bothers me. I'm one of those that finds out something's wrong, reads up about it and researches it and does whatever I can to help (my MH team have always said I'm one of the most 'aware' people they've dealt with) but there's no doing that in this situation!

laurenamium Tue 25-Nov-14 08:13:24

I'm 18 weeks and my scans every fortnight start at 20 weeks, they said it only really affects it (if at all) from 20 weeks onwards so no point in lots of scans before then.

You sound a lot like me! I felt so much better when they gave me aspirin as it makes me feel like I'm doing something proactive to help every day rather than just sitting and waiting iyswim! That and making sure my diets good in the meantime to feed the baby up with healthy foods grin

I have my 20 week scan on 8th and a consultant meeting afterwards so I will post up anything new I'm told!

KittyandTeal Tue 25-Nov-14 10:19:22

Ah that's great.

My scan is 13th jan atm, although they're deciding if they're going to bring it forward. I don't think they'll bother tbh, especially if it doesn't start making a difference until 20 weeks.

I'm not sure if they'll give me aspirin because I've had bleeds in my previous pregnancy.

Can I ask what your Papp level was? I guess I'm worried because mine seems lower than others that I've been able to find online.

laurenamium Tue 25-Nov-14 11:25:26

I've had bleeds in this pregnancy and they've still given me it, it's worth a mention!

I don't actually know my blood result hmm I forgot to ask at the 16 week appointment and the midwife said they had forgotten to put them in my notes. Where in my notes will they be? Ill have a look and see if I can find it!

KittyandTeal Tue 25-Nov-14 12:30:59

Mine were on the scan letter. I got a breakdown of all my blood results plus a letter saying that the levels were low.

I will definitely ask the midwife tmrw when she calls about aspirin. Good to know it's an option even if you've had bleeds.

It's a massive relief to find someone going through the same thing. I'm a bit tearful today, I know I shouldn't be. I guess it's hormones!

laurenamium Tue 25-Nov-14 12:44:47

Oh I never got one, just the letter explaining that because it was low I was to take aspirin, have more scans and confirmation of the extra scan dates! Ill chase up my numbers though!

vinoandbrie Tue 25-Nov-14 12:51:02

I had extremely low Papp-A. I had the harmony test, which came back all clear, and I had a healthy sized baby back in April. The low Papp-A caused me a lot of stress! I had one extra scan at 32 weeks.

KittyandTeal Tue 25-Nov-14 13:07:29

That's good to hear vino (not that it caused you stress!)

There seem to be lots of positive stories around so I've got fingers crossed.

I wasn't actually that worried till I started dwelling and googling (stupid woman that I am!)

KittyandTeal Wed 26-Nov-14 18:04:45

So I spoke to the screening midwife who was lovely.

She said the director of fetal medicine has looked at my results and said that because all the other levels were good then they're just going to treat me as a 'normal' low papp level. She's going to look at my anomaly scan when it's done.

They've also brought the scan forward to 18 weeks and left my 21 week scan in place too just in case.

She said the risks they're concerned about is slow growth and pre eclampsia which is great (wouldn't have been great a few weeks ago but after the horror stories I've read it's wonderful news!)

I'm feeling much better about it all, especially knowing they're keeping a close eye on it and also I'll have lots of different people looming at the scans.

The best I can hope for really.

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