Low papp-a and hcg

[Smurfsrock]

Hi, just seen my 1st trimester screen results (am now 21w) and a bit worried!

Papp a was 0.32
Hcg was 0.36
NT was 1.6mm
Low risk for all trisomies, no soft markers seen.

20w scan baby seemed time, good size/larger than average. MW hasnt mentioned anything but i've read heaps about low papp a being associated with poor growth, placental decline, premature birth etc so am rather worried!

Anyone else had similarly low biomarkers? What was the outcome?

Ask the MW if you can be referred to speak with the fetal medicine consultant or another consultant in your hospital. You're right that low PappA has a risk of placental breakdown - the evidence isn't particularly strong but I had similar results to you and my consultant was more than happy to plan in extra growth scans from 22 weeks and advised I take baby aspirin also.
Unfortunately for us our baby had Edwards syndrome which is associated with low pappa and hcg it would never have been picked up on our 12 week scan and I came back low risk for trisomies but had the harmony test and found it surprisingly that way and it was confirmed by CVS. I don't want to worry you - I'm sure they'd have seen any issues on your 20 week scan honestly if there was a problem. But do speak with the doctor - be proactive and ask for growth scans. Your baby and you know best

I had low PAPP-A. Growth scans from 28 weeks onwards showed declining placental blood flow which eventually started to reverse and DS was delivered at 36+6.

Hi, I have low Papp-a too (0.27MoM)
I've had my consultant led Doppler scan appt now (I'm 26 weeks) and she said that between 0.2-0.4 is a bit of a 'grey area' and that anything below 0.2 is the real low. Apparently they've changed the cut off to catch the pregnancies where there might have been an issue and it not investigated.

All was well at my scan.
I have a growth scan booked in around 32 weeks. I'm feeling much more positive now but I was initially terrified at having 'abnormal' bloods...

Just jumping in here as I'm going quietly out of my mind. Had my first scan last week at 13+4, scan was good, sonographer happy, left all cheery only to get a call the next day to say my hcg was 0.1mom. Had the harmony test the next day so still waiting for those results (I'm not a patient woman) but after consulting with Dr Google (who is a scaremongering sod) the only info I can find is that my hcg is so low I'm not actually pregnant, but I have a scan picture that shows a baby, with legs and arms and other expected features. So now I'm confused and stressed, not sleeping or eating (good practice I guess should all be well and baby does come along). Tried contacting midwife who seems to have fallen off planet so just going quietly insane while the other half repeats his positive mantra of 'I'm sure it's all fine'. Any positives I can cling to?

So sorry to hear your baby had Edwards syndrome KTD27 it has crossed my mind that maybe I'm that 1:7000 that might be positive but I hope there would've been something unusual at 20w, baby was reasonably big and I read T18 babies usually have a small A.C so hopefully that makes it less likely.

Thanks PrincipalCelestia, that's really reassuring to know. I've previously had really big babies so was going to request a late growth scan anyway in case this once was over 11lbs... not looking so likely I'll have to worry about that now I guess! I was hoping (and had been) to really relax and enjoy this pregnancy as will be my last but now I'm just going to worry until baby's born!

Emimayb, isolated low hcg is less of a worry, much more variation in levels. Mine was lowest 5% early in last pregnancy but all was fine. Hope your harmony test comes back normal x

Thank you smurfsrock, Papp was low too but midwife at hospital didn't seem too bothered about it, hopefully that in itself is a good thing

I had low papp-a with my second, I think it was 0.40MoM or something like that. My hcg levels were slightly low at 0.8MoM. Doctors weren't worried about the Papp-a results and said that they'd only recommend monitoring if it was below 0.3MoM. My trisomy 21 results were 1 in 1922.
I did pay for a private scan at 32 weeks to check growth and the placenta and it all looked fine. I gave birth to a healthy little baby weighing 3.8kg!

My Papp A was 0.328 MOM, my B-HCG was 0.413 MOM, NT was 1.5. My daughter had T18.

However there were anomalies on the 20 week scan (would not have been noted if we had not had a consultant review however, they were about to send us home)

Abdominal and head circumfrence also measured small at 20 weeks which was the classic T18 sign

So sorry to hear your daughter had T18 TheDisillusionedAnarchist. Undiagnosed T18 has been playing on my mind a lot I must admit, although baby had a big head and AC so really hoping that makes It less likely. So hard not to worry though!

Whilst I am no medical professional I had low Papp-a and was given growth scans and they expected her to be small. DD was born 10lb6!

Just to update for anyone in future i'm now 36w and had a scan yesterday (for other reasons) and baby is looking a good size (on track for another over 9lbs) with normal placental dopplers. Haven't had any extra intervention at all

That's great news @Smurfsrock !
I'm 38 weeks now and at my growth scan (at 34 weeks?) baby was measuring along his curve and seems he's going to be an 8lber.
Placenta Doppler normal at 23 weeks. All signed off from consultant re low Papp-A.

I felt much more relaxed mid way through pregnancy, nearing the end now and I'm getting a bit anxious about getting him here safely!

Hope you have a healthy rest of pregnancy

Hi everyone,

I'm in the same boat. 13 weeks with clear US but my blood tests have come back with 0.24 PAPP-A and 0.45 HCGb.

Am frantic with worry which has been made worse by my antenal clinic telling me they don't analyse those levels in Wales. But midwife in England has confirmed for me that they are low and should be monitored.

After a few phone calls have managed to get a midwife to speak to a consultant about my results! Am scared but even more scared I won't be monitored and I'll miss the chance to help my baby in any way I can.

Praying someone takes my worries seriously. Anyone else in Wales?

I know this is an old post however I wanted to put something out in the ether for anyone that found solace in these message boards, following not so good blood work and looking for answers and hope from Dr Google.

From my 12w bloods I got Low Hcg - 0.34 and Low Papp-a - 0.26 and was given a 1:40 chance of T18 Edwards / T13 Patau. But was low risk for T21.

We opted for Amniocentesis and thankfully the results were good and have been cleared for all 3 Trisomy's.

I am still waiting for the next hurdle of the 20 week scan and am still going to be high risk with the low Papp A.

Just found this thread as I'm worrying about my low Papp-A. Mine was 0.12 in the first trimester but they don't do any extra growth scans here, they just measure bump and make sure I'm still plotting the line. I'm just worried as I'm carrying small and I know there can be placenta issues. Are the measurements the Midwife does really accurate or could something be missed?