Low PAPP-A, low HCG, 1:506 chance of Edwards' & Patau's...

[Joni13]

Hi,

I had my screening results back today, with hCG of 0.4389 MoM, and a PAPP-A of 0.2755 MoM.

1 in 506 chance of Edwards' and Patau's (v low risk Down's Syndrome).
I'm 36.

I called up the hospital to get more info and was told a midwife should have called me to tell me to start taking aspirin as my PAPP-A is low. They talked me through the rest, and the jist was that screening results are complicated, but she isn't concerned about the results.

But the more I think about it and the more I read, the more worried I am, and wondering whether I should pay for the NIPT.

Has anyone had similar results? What did you do/what was the outcome?
TIA

Edit to add, NT was 2.00mm, CRL 73.1.

The screening has actually reduced your age related risk of Downs from 1:350. The low Papp A offers an explanation for why your risk did not fall further. You have not been identified as at high risk of having a baby with a chromosomal abnormality.

That is only just a low Papp A (normal is above 0.45 MoM) and other than taking aspirin and offering additional growth scans, there is not any particular action that would be recommended.

Low Papp A is a very poor test for screening for growth restriction (hence scans and aspirin), but cannot be ignored once it is known about.

The test that you have had will identify 98.4% t21 pregnancies (as well as a lot of unaffected pregnancies), NIPT 99.9%.

If you are going to spend the next 6 months terrified that there is an underlying chromosomal abnormality then I would consider £350 money well spent and reassuring, but it will not be organised by the NHS.

@khaa2091
Thank you, but I didn't list my down's syndrome result (which was adjusted 1 in 1,756). The result I listed was for Edwards' and Patau, which is 1 in 506 adjusted from age-related chance of 1 in 2,497.

It's the low PAPP-A plus the low hCG that is worrying me.

Apologies for misreading.

If it is worrying you then just think about private NIPT.

If you are worried I would recommend the NIPT. However it’s worth pointing out how the NHS screening odds work. That risk is of people with exactly the same hormone levels, age etc as you. So it’s probably lower than you are imagining.

I had a NIPT on the NHS and the results did take a while to get back which was difficult. This was for a Down’s syndrome risk of 1 in 60 which the NHS counted as higher risk but not high enough to go straight to amnio.

I also think the NIPT is slightly less accurate for Edward’s and Pattau.