Low PAPP-A

[MeganBistram]

Hello

I got my results from my 12 week scan this week. And have an incredibly low PAPP (0.2) MOM. The others came back as low risk. Although Edwards was 1-395 which seems quite high to me. This is my first pregnancy and all was fine with the scan. Should I be worried? I am considering taking the harmony test? Do you think it’s worth the cost? Also is there anything I can do to increase my PAPP?

The testing for PAPP-A is new - I didn't have it with my first dc. It's the level in your blood so I don't think a harmony test will help and the leaflet I have just mentions aspirin and various checks with midwife... Did they not give you a leaflet to explain? If you're concerned call your midwife but try not to worry.

Hello

No leaflet, just got a letter in the post saying it was low and therefore I will have extra monitoring (scans at 28 weeks and 32 weeks) no mention of aspirin or anything I can do to help it? Do you think 1-395 is quite a high risk for Edwards?

I think a harmony (NIPT) test will help in that it will clarify whether your baby has Edwards, and that might help with reassurance. Obviously expensive reassurance though

That is very low, but With no other factors I guess their concern seems to be a small baby?

Funnily enough you’re the second person I’ve heard of who has had this with no further explaination

I had low PAPP-A and it turned out my baby had triploidy (3 of each chromosomes instead of 2, fatal disorder). My baby was also measuring 2 weeks behind at 12 weeks.
I wouldn’t worry about Edwards, that doesn’t sound high to me. I was told it’s 1:250 that they consider “high risk”. Mine was 1:5
I do hope everything goes well for you and you have a safe pregnancy. I think because what I went through I would at least call the midwife/doctor and ask for some reassurance. PAPP-A is meant to be close to 1 so yours is low but then your risk for Edwards isn’t that high

It’s terrible that you’ve been given no information. Is there a number you can call? I had low PAPP-a and was offered an invasive test to rule out Down’s syndrome (either an amniocentesis or a CVS). Perhaps at 1-395 they don’t think the risk is high enough to offer the test. That’s a 0.0025% chance (I think! If my maths is right). Did they say what your risk of downs was?

I had additional scans at 28, 32 and 36 weeks to check the baby was growing ok. At 36 weeks they were worried that the growth was slowing down and the blood follow from the placenta wasn’t as healthy as it should be. They decided to induce birth and my son was born 2 days later. He was a little underweight - just under 5lb - but otherwise fine. He’s almost 8 now and completely healthy.

I don’t think there’s anything you can do to increase your levels unfortunately, but they good thing is they are now aware of the risks and can make sure you’re monitored and treated accordingly.

Good luck and congratulations on your pregnancy.

My downs was 1-1095 so less worried about that and scan everything was fine and measured exactly as should be. I think the Edwards is higher due to the risk of having low protein. I think having the extra test ( all be it expensive) will put my mind to rest.. also another excuse to see baby again :)

My SIL had low PAPP-a and had to have additional scans to monitor growth. My niece was over 9lb when she was born so the low PAPP-a didnt stop her growing!

Can you ring your midwife to speak to them if you are worried? You'll get to discuss the results at your 16 week appointment, I'm not sure how far away that is for you?

My blood test gave me a 1 in 17 chance of Downs Syndrome, I had the harmony test on the NHS and it came back as 1 in 50,000. From doing research, the blood tests often give false positives.
You are only considered high risk if your results are 1 in 150 or lower (in my NHS Trust anyway).

Oh well the downs risk sounds low. Mine was considered “high risk” at about 1-110 (I can’t remember exactly but definitely less than 1%). I think research has come on a long way since my pregnancy 8 years ago - the harmony test was quite rare then I think. It definitely sounds like a good option for you, although your risk is relatively low (but I did get my maths wrong! It’s a 0.25% risk, or a quarter of 1%. Sorry - stats not my strong point).