Low HCG, high PAPP-A, high NT

[Kah09]

Hello!

I had my 12w scan yesterday and baby had an NT measurement of 3.8mm which they said was larger than they'd like.

All other structures/organs looked fine and my blood work still made me "low risk" - 1:233 for Down syndrome, 1:587 for other trisomy's, however this was due to my bloods being high in PAPP-A and low in HCG

(HCG 0.30 MoM and PAPP-A 1.38 MoM)

I'm awaiting harmony results as I think a low HCG could indicate Trisomy 18 or something but I'm also now worried it may mean the placenta is not doing great/spontaneous delivery later down the line.

Has anyone else had low HCG and high PAPP-A?

I had exactly this. It was an awful time, as I'm the grand old age of 37 my risk was 1/13 for downs and 1/14 for Edwards/ Pattau. I had a cvs and all was fine. DS is almost 9 months now but I often revisit these threads to see if I can give advice. I was at kings and due to the low Papp a they did growth scans at 28/32/36 weeks. All was fine and they also recommended induction on due date. I got the feeling I could have asked not to be and they would have compromised with going say 7 days overdue but I had pretty bad anxiety about still birth and was more than happy to be induced.

One thing I would say is not much is known about low Papp A, my midwife was useless about it and I had to push for a consultant appt, the consultant suggested induction, don't be afraid to ask for this if your midwife isn't much help. I really hope all is ok for you, let me know if you have any questions and I'll try to help

Sorry can't give much advice. My hcg was low as well as some other blood results were out of normal range.. I had regular growth scans every 4 weeks. My dc is 6 now and absolutely fine! Sorry can't be more helpful it was a while ago so can't remember the ins and outs. All the best, hope all goes okay.

Thank you so much ladies - really appreciate your comments and the time you've taken to help. I'm taking comfort in the fact that the NT wasn't overly high (in the 6+) and am awaiting the call.... 😱

What I wasn't sure on, is whether or not to have an amniocentesis even if all comes back fine from a harmony test, because I think the harmony test just re-tests for the 3 most popular chromosomal issues and not all of them and an amino I think detects lots more. Now they've said I've got higher risk of "chromosomal/genetic defects" I'm thinking gosh... I will always worry now throughout the entire pregnancy, as I wouldn't want to cause baby unnecessary pain or suffering.

Anyway, I'll be sure to update the thread whatever the outcome is, and thanks once again x

I had a cvs as well as harmony, it was such a huge shock when I got my odds. It was also very close to Xmas and I still had 10 days to wait for harmony results whereas cvs was 3 days. I didn't care about knowing before Xmas but I didn't want to find out something was seriously wrong and have to wait an extra 2 weeks over Xmas etc for a termination if that had been my decision. It was good to know that everything was fine. but my understanding that the harmony is 100% for downs but they aren't allowed to market it as that. Anything really serious would probably show up on a scan (again this is just my understanding) for me it was important to know 100% that all was fine but only you can decide that. Sorry I can't be more help.

Another thing you might want to ask your midwife about is baby aspirin, they sometimes recommend it with low Papp a. If they don't know ask them to find out. I saw the consultant at 26 weeks and at that point it was too late to start taking it, but all was fine anyway.

I have not heard of high Paap-a. You are opposite from my experience. I have low Paap-a and did amniocentesis more than a week ago. Wanted harmony but basically two midwifes said go with amnio especially when we knew what our decision would be in case of confirmed syndrome. Amnio results came last tuesday and was a relief to get them back so quick ( 3 days) . Awaiting for some other results for heart issues.
Its very hard time. Stay strong and positive. As long as doctors saying baby is fine, developing well there is nothing to worry about. My friend had two huge babies that even doctors said no to natural delivery. Maybe in your family you have really tall/big bone people? :)

I'm a type one diabetic with good control, but this probably has affected the baby a little and I'm hoping it's just because he or she is growing a bit larger... I'm also taking baby aspirin and have been for the full duration so that's a relief.

I suppose I'm rushing 10 steps ahead in my head, with 'what if's" when really I need to take things one step at a time... if Harmony comes back ok, then I can assess whether I would like further re-assurance with a cvs or amino, or just wait for a few scans.

How long did you ladies wait for your harmony results? It's one week tomorrow and some people say that it's 7-10 days, but others 2 weeks. Do the firm call you themselves or does the doctor/team who sent the test off?

Sorry for the 21 questions! Feeling a bit more positive today. I have faith in my body and baby ! Ish. Haha.

I had my Harmony test on the Saturday and got my results the following Friday so hopefully yours will be back soon and bring good news

Hi ladies - just a quick update - my harmony test results came back in a week and all was low risk thank goodness. I had a specialist cardiac scan just on the heart today at 14 weeks and all looks perfect, so they said they're confident ruling out any serious heart abnormalities for now. On to the first anomaly scan in 2 weeks time! Thanks again for your support. Could hug you all... the messages meant a lot during a time of frantic information gathering x

Just in case anyone reads this thread searching for information, I'm 17 weeks now and baby looks perfect!! I've been told that HCG level is of no consequence as that's what tells the body it's pregnant and by 12 weeks you most definitely are and it will reduce anyway.

Plus, i saw a consultant yesterday for a private scan and he said that increased fluid around the neck at 12 weeks, in babies who are otherwise anatomically fine, is almost certainly due to the fact you're likely to be having a BOY 😊. But it's a lesser known fact.

Kings college have been ok but have scared us at every scan, even telling us that they didn't see a nasal bone at 12w (when it was written that they did) and at 16 weeks it's a bit short which is a sign of chromosome issues!

Specialist consultant said it was rubbish, everything looks perfect, can find no fault in baby because there are none and that many measurements they take were done many years ago on scanners which weren't as high tech or accurate now.

Hope that helps people with higher NT who may be panicking. X

@Kah09 thank you for the update, I've been following this post as had a scare with my blood hormones (NT was only 1.6 but I'm age 38) and ended up having CVS last week. Also came back with a good result. I'm so pleased all is well with you and your baby - are you going to find out gender before birth? Please keep us updated on whether boy or girl if so!!