Anomolies after 12 week scan - small baby?

[Jackbb]

Hi Mums

Hope you don't mind an expectant father joining the ranks for a bit, i can do with some of your advice and i hope words of wisdom from some of your experiences.

My wife and I have just had our 12 week scan results that showed we were at overall risk of Down's by 1 in 440, a scan measurement of baby (CRL): 59.2mm and that the wife's PAPP-A Level: showed 690 miu/L / 0.29MoM (below average which is 0.30Mom).

My concern centres around the fact that we might be asked to attend extra growth scans of our baby as the hormone levels (PAPP A) are below 0.3Mom and to see whether this maybe an indication of a small baby!

I know that we are just below the required levels but it doesn't stop myself and the wife from becoming a little concerned that something isn't right and that the baby is going to be too small or at risk. This is our first child and we are excited and amazed already by the whole process but following this news we have become a little nervous.

Just wanted to check with you mums to see what similar experiences some of you may have had in relation to our recent news. Am i being unnecessarily worried?

Be great to hear from some of you and at least put my mind at rest?

Thanks in advance.

Jack

Welcome to MN Jack. I didn't want to read your post and not reply, but really it's so technical that it's hard to comment. What did the sonographer/MW say about all these details? It sounds like you could be a bit like my (mathsy) DH who went over all the measurements with a fine-toothed comb. Really most of them are just guidelines and given that they're averages rather than absolutes they don't tell you a huge amount about your baby at this early stage.

Have you been asked to go back for more growth scans or are you assuming you'll be asked?

Hi Jack.

I googled 'average crown rump length at 12 weeks' and came up with 54mm. Looking at my notes mine was 81mm but my '12 week scan' wasn't done until 14 weeks gestation, so that's why.

I don't know much about PAPP-A levels but I believe they use the level as part of the calculation in working out your overall risk of downs syndrome. However, I assume your figure of 1:440 which they have already given you takes into account the results of this blood test?

Not sure if that's of any help?

I work at the institution which developed the Bart's triple test. I was asking my colleague about my own PAPP-A and HCG levels and constituted the normal range. She said that more hospitals are actually taking account of PAPP-A outside of the Down's screening tests because of links with placental insufficiency and IUGR. However, there isn't enough research to support any hard or fast rules. I guess 0.29 does not certainly guarantee a small baby or other risks but is a marker for close monitoring. I will speak to her again about your level and come back with update.

We had our 12 week scan recently also and wanted to see if baby was in the normal range for growth, I found the same stats as pp who said average for 12weeks is 54mm so 59.2mm seems more than fine. Unfortunately I cant comment on the other stats, I'm sure the information sh77 can give you is far more accurate anyhow. Best of luck.

thanks all for your posts - just to update, we have been told we may need to return for further growth scans depending on what is discovered on our 20 week scan. The annoying thing was that the sonographer was rushed as she was late setting up (we were the first appt of the day too!) so the measurements might have been slightly skewed.

SH77 - Be great for further information from you if you can get it.

Anyone else able to add any views on this topic?

Jackbb
i cannot add anything, but wonder would you benefit from the peace of mind of a private scan. So you get lots of time with a sonographer, ask all the relevant questions and see what she comes up with re:measurements?

jackbb - not sure if you are in london, but if you are you might want to go for a private scan (I advised a friend to do this, who had abnormal results) and they did a very detailed scan etc, and all is well (she also had low PAPP results)
I think it might be useful to get someone to do this type of scan, who has the time, best resources etc.
Nikolaides in london (you can google, or if you are intersted i will look up the link) is well known for doing very accurate tests.

I would also recommend Prof Eric Jauniaux at Portland hospital, Dr Demitrious Economides at MyScan or Dr Guy Thorpe-Beeston on Harley Street. All are well known fetal medicine experts and do scans...

I didn't get PAPP results yet, but my baby was measured at 12 weeks (yesterday) at 55mm... was told it is normal, and yours is bigger...

Jack,

I had low Papp-A levels too. I'm 32 weeks along now and have had a growth scan at 28 weeks where our little one measured exactly average on all measurements. We have another 2 growth scans at 34 and 36 weeks.

Low Papp-A is an indicator of future issues with birth weight and placental function but it is just an indicator and not a definite problem. Be guided by your Obs team and try not to worry too much - easier said than done, I know.

Best of luck :)

Thanks all for taking the time to reply.

Seems to be a lot of people out there with similar experiences. Looks like its nothing to get too worked up about by the looks of it!

There's so many people on here!! Great stuff.

Jack

Jack,

We did not get so many details at 12 weeks with either of our babies BUT, to the best of my knowledge, unless you know exactly when you conceived, the 12 week scan is assumed to be normal length and is then used to calculate your due date. It is only at the 20 week scan that measurements are used to detect anomalies (hence "anomaly" scan).

As a general rule, as a slightly overanxious father (now on our second pg), there are quite a few things that can come just outside the normal range but be of little concern to the professionals. It is good to ask the questions but if the midwife/obs says it is normal, it is best to take their word. Otherwise, it will be a VERY long 9 months for you both.