Confused about bloods results

[Olivetti]

Hi
I got my results by phone a couple of weeks ago, combined risk of 1 in 100,000. All wee and good, so I thought. But the letter came through today - don't the blood results look bad? I thought they were supposed to be c 1 MoM?

HCG: 0.43
PAPP-A 0.88

Does anyone know more?? Thanks

well and good, not wee and good

that's what i thought too... might be worth phoning and checking...

Hmm. I can see why you are questioning the risk result as the bHCG does look low. However, a risk of chromosomal disorder isn't as simple as 'how close to 1 are they' - I assume your risk of 1:100,000 is for down syndrome specifically? Bloods would indicate a higher risk of down syndrome if bHCG was high (way above 1) and papp-a was low (way below 1), so for example bHCG 2.5, papp-a 0.3. Your results aren't in that pattern. Also combined in your result is your age (are you quite young?) and the nuchal fold measurement.

It is worth calling Antenatal Results and Choices for reassurance as they are the experts, but personally I wouldn't be concerned about down syndrome from your results.

My Papp a is low 0.28 so I'm having extra scans for growth.
My downs risk is 1:350 but they said this is low risk.

Yes, the result is for Down's Syndrome. I rang them and they said my pattern was good, and that they erred on the cautious side in any case, and had no concerns. But I have googled (bad idea) and found that low HCG can be associated with other things. I asked them about this, and they just repeated that the consultants had no concerns.

I am 34, so not young, but not old.

NT was 1.4mm, which is 1 MoM

That's a good NT. Are you worried about other chromosomal problems?
You might like to ask your midwife for a consultant appointment so you can talk it through and ether have your mind put at rest or consider CVS/amnio.

In my experience, the consultants are very quick to act early on anything they're concerned about so I am pretty certain that if they had any doubts at all they'd be seeing you now, if that's any reassurance. But I'm sure they'd rather spend 10 minutes with you explaining the results than have you sitting at home getting stressed (or googling yourself silly, which is my trick).

Olivetti, I'm glad that they have confirmed for you that the pattern of results was good. I would believe the consultant, and not Dr Google myself... ;-)

Desperatehousewife, I had low papp-a in my second pregnancy and googled (silly me) to find out about the risk of growth problems. Anyway, this was all part of a high risk down syndrome result but a CVS gave me the all clear, but I did fret about the growth thing. The hospital didn't offer me any growth scans, but I paid privately instead (silly me, again!) and all was well. He was born by planned section (unrelated reason) at 39 weeks weighing a good 8lb 6oz, so no growth problems there! Just thought I'd share.

Pretty - they told me not to google (!) and said the important thing was the patterns. I spoke to the fetal medicine midwife, and then I rang the Wolfson Institute, who are experts in this sort of thing. They said the same thing. I had read somewhere that levels of HCG lower than MoM 0.5 warranted investigation, but they disagreed with this. I have read of a possible link to trisomy 13, but they said there was no pattern present.
I know I'm probably being silly, but it still nags away at me. They said I didn;t need to see a consultant, as they would just tell me exactly the same thing, and certainly would not advocate any further testing...

Well, if you have spoken to Wolfson then you have spoken to the most expert of experts so try let that reassure you that your baby is doing ok. You're not being silly at all. Pregnancy is an anxious time and most of us have a bit of worry the whole way through, but you need to balance it against the facts in this instance, which is that you have a NT of 1.4 (fab) and no pattern which would suggest even more diagnostics, let alone the need for invasive testing.

So you're doing great. Step away from google unless you're booking a spa day/mini break/years supply of chocolate...x

Thanks mummytoh that's v reassuring! I've got my 20 week scan on fri and they're going to check blood flow to the placenta so fingers crossed all is well.

I had such a straightforward first pregnancy it's a bit worrying but I'm glad they're monitoring me closely.

Olivetti, it's great that the Wolfson Instiute also say there is no pattern in your blood results and 1.4 nuchal is excellent. Well done you for taking the initiative and calling them, that sounds like something I would have done!! There are no guarantees in life, and pregnancy is an anxious time, and that's what makes pregnancy so hard. But your odds are very good, much much better than most. (sooooooooo much better than mine were and my second son is a wonderful, if cheeky, 14m old)

Desperatehousewife, I would feel very reassured if I was having the blood flow to the placenta checked, and growth monitored, I think they're looking after you very well. I think I fretted because I wasn't offered it (postcode lottery again, I expect!). But as I say, there's unlikely to be a problem. Thinking back, I also asked ARC about the papp-a thing, and they said that there was no reliable research evidence to support the link between low papp-a and growth problems, sorry I've just remembered that. It's good that your hospital is being cautious though, sounds like you're in good hands.