Low levels of PAPP-A

[sammylouise56]

I had a letter saying that they detected low levels of PAPP-A in my blood, should I be worried? Will everything be ok with my baby and can I go on to have a healthy and fine baby?
Sorry just so worried now!

I have this too. The advice from my hospital was that it may indicate that the placenta isn't functioning properly so I was booked in for regular growth scans and advised to take 75mg aspirin daily. All good so far, with baby measuring exactly on the 50th centile at 30 weeks.

I understand that if growth drops off towards the end of pregnancy the consultant may suggest that I'm induced. The main thing is that the baby / placenta is being observed regularly so I feel I'm in good hands!

Also aware that this can be a soft marker for Down's syndrome but this hasn't been mentioned to me at any point. My risk for DS did increase substantially but was still low overall so I'm trying not to worry about it.

Just my experience but hope that helps!

Hi,
I had my screening results today which showed Papp a MOM 0.39. My overall risk was low and I’d already had harmony test which showed all clear. My concern is when I asked about the low Papp a she said it’s not policy in my NHS trust to do anything at this stage because the research is new and it’s under review. Other neighbouring trusts prescribe aspirin and extra scans. I’m worried and considering paying privately for the growth scans and placenta checks although I’m unsure when these are done?

Hi OP - my fist pregnancy (back in 2017) tested positive for low PAPP-A. I got extra scans done throughout the entire pregnancy and through all the scans she was measuring just fine. They even told me at one point that she was a big baby! Kinda intimidating to hear being a FTM and planning on a natural birth.

Long story short, i ended up having a emergency c-section (unrelated to papp-a levels) and she was actually smaller than they thought (3.555kg) but still a relatively normal size. She came at exactly 40 weeks.

Shes now 17 months old, walking, saying some words and a perfectly healthy girl.

Hi OP - I also had this with my first pregnancy, v low levels (something like 0.2mol iirc). I was told that it can be a soft market for down’s (had panorama test so that was n/a for me) and also correlated to IUGR (NOT a causative link). I took aspirin to 36w and had monthly growth scans from 24w onwards. If it’s any consolation it was a normal pregnancy (albeit with horrible hyperemesis) and DS measured consistently large throughout. He arrived at 37+6 weighing a very respectable 3.7kg - he would likely have been 4kg+ had I made it to 40w.

If you are worried and your doctor won’t do anything, you could always just take the low dose aspirin until 36w and book a couple of extra scans at 24/6w and 34w for peace of mind?

In both my pregnancies I had low papp-a. It’s just a risk factor into potential issues that could arise through your pregnancy, my dr advised to take aspirin, but my midwife hasn’t even heard of it! I believe research is still new into the implications of this hormone so don’t google too much.

Both my babies were small, I had a really rough pregnancy with my first with high blood pressure at the very end, but my 2nd was relatively smooth! My first is now a fiesty 22month old and 2nd is a perfect newborn.

Just remember low Papp-a is a risk factor it doesn’t mean that certain outcomes are a given x

I had this with my second. My placenta blood flow was checked because of the PAPP-A result, and was abnormal so I had monthly growth scans & was induced at 39 weeks because my baby's growth was slowing.

I had a great induction/birth & a beautiful healthy baby.

If anything, I felt very well looked after during pregnancy because of this.

...And I also took 150mg aspirin too.
My baby was nearly 7Ibs so a good weight

I had it with my 2nd. Had daily aspirin and 4 weekly growth scans from 28 weeks. Was measuring big - just under 95th centile throughout.

Eventually induced at 38+2 because I had a couple of episodes of reduced movements and we were concerned about size after I'd needed a ventouse with my 9th-25th centile 1st baby!

Actually he was 8lb so not massive but equally needed an easy ventouse so would probably have struggled if bigger!

I had low Papp-a in my first pregnancy. I had additional growth scans at 28, 32 and 36 weeks. At the last scan they were concerned about the baby’s growth and the blood flow from the placenta, so they decided to induce me at 36 weeks 2 days. He was a little small - just under 5lb - and needed to stay in hospital a few days with a glucose drip to maintain his blood sugars. He was fine after the first week or so though.

My second pregnancy was fine - Papp-a normal and went full term and a natural delivery.

I know this is an older post. But I just received my letter today showing low PAPP--A levels. But my GP is prescribing me 150mg of aspirin which seems more than I've read other women have gotten. Also I've still not received my combined test result and it's almost been 2 weeks. I'm 15 weeks today and starting to worry.

I had my 20 week scan yesterday and was told I had low Papp-a levels which were identified at my 12 week bloods. I had my letter through after these results and there was no mention of this just I was low risk for three screenings. The midwife seemed to think I already knew about this which I didn’t and said I would have growth scans and be induced if he was small. After reading lots of post everyone seems to have had results in the post and some people prescribed aspirin. Called the hospital this morning to ask what my levels were as no one told me and did I need aspirin and was told they’ve just got a note saying it is low. First child and feeling nervous and also left in the dark as how can they said I have low levels but not know what it is??

I've just had my low pappA baby 3 weeks ago. Perfectly healthy and weighing 8lb 2oz. Had growth scans every 3 weeks and no aspirin as I'm allergic. Docs said it's not a huge concern if everything comes back normal. Most woman and babies are not affected by it at all.

Hi did anyone have an impaired placental blood flow?

I had low papp-a with DD2 and was booked in for growth scans from 28 weeks. She was on the small side and from 32 weeks the placental blood flow started looking a bit iffy and basically got worse from there. Also had bouts where she would stop moving for days at a time so was in and out of hospital and by 36 weeks having 3 scans a week. Her growth really slowed and placental blood flow was not great at all, off the chart high pressure. She was delivered at 37 weeks by c section (they would have induced but following horrific induction with DD1 I'd already been put down for elcs by 41 weeks and over induction if it came to it). She was perfectly healthy and needed no extra help, just a teeny tiny 2.5kgs. She's still a midget now but feisty and thriving at 16 months.

@spydie Did they check you placental blood flow at your 20 week scan or the 28 week scan? If so did it look fine then or was there already a concern?

Mine is impaired from the 20 week scan and I don't know if it just gets worse or stays the same x

@girlanonymous blood flow only started being checked from 28 weeks and at that point it was within normal ranges.

As I understood it, cord pressure is meant to decrease as pregnancy progresses, not increase, but I don't know much more than that! Hopefully your consultant is giving you some answers?