what should a normal PAPP-A and hCG result be at 12 weeks - v confused

[jollyjellybean]

I had my 12 week scan at 12 + 4 and got the following results
NT 1.70 mm
Free beta hCG 2.80 MoM
PAPP-A 2.02 MoM

I understand that the NT result was OK which is really encouraging but I don't understand if the HcG and PAPP-A results are OK or not ??

Does anyone know what the normal levels of HcG and PAPP-A should be at about 12 + 4?

Any advice greatly received as Im panicking to check everything is ok

They should be 1.0MoM no matter what the gestation as they're normalised results based on gestation and your weight and a few other factors (smoking etc). 1.0MoM is the average - hardly anyone has the results right on the button and most are quite a bit out!

The NT is great as you say.

The bHCG is a little on the high side. There's a few benign reasons for that - did you have IVF, or have you had any bleeding? They can cause it to be high. Girls tend to have slightly higher bHCG too. Or sometimes it's just high because it is. High bHCG is actually one of the less worrying markers.

The PAPP-A is high, but not alarmingly so. PAPP-A is only worrying if it's low as that can mean later growth issues. If it's high it often means you have a fantastic placenta!

In terms of a "profile" for chromosomal issues I believe (somebody please correct me if I am wrong, not 100% certain) that high bHCG and high PAPP-A are low risk for all the things they test for, so I guess you'll probably have a low risk result? Depending on age of course.

Keep us updated with your results!

thanks so much for your reply CrispyFB - that's very helpful and very kind of you - many thanks :)

I haven't had IVF or bleeding but am expecting a little girl :) so Im hoping that this will account for the higher HCG

Its reassuring to hear you say that high HCG and high PAPP-A are low risk for all the things they test for

If anyone knows differently what a high HcG and a high PAPP-A result could mean it would be great to hear

Im greatly reassured by my NT result but am now slightly concerned that my HCG and PAPP-A are on the high side

Put it this way, my bHCG was 5.43MoM this time out and nobody is bothered particularly. I have to have an extra growth scan in the third trimester, but it's more to just make certain all is okay rather than an actual concern. Yours is half mine - it's only usually a concern that high if you had low PAPP-A as that would fit the profile for T21. It's very common indeed to have quite high bHCG, mine was just over 2.0MoM last pregnancy. Neither baby has chromosomal issues that we know of.

As for the PAPP-A, there's this research document (ten years old, but probably still relevant): www.ncbi.nlm.nih.gov/pubmed/12749035 - and this is for women over 5.0MoM!

"We conclude that women with high PAPP-A can be reassured that there is no reason to suppose that the outcome of pregnancy will differ from those with normal levels, provided other markers are normal."

Everything online points to it just being a really good placenta!

It does look like everything is okay - better than okay even because of the high PAPP-A - try and see it as a good thing! It's high, but not "high" if you see what I mean - it's within parameters.

It's also really normal to worry over everything too The reason I know this stuff is my obsessive researching because I worry so much!!

ahw thanks so much CrispyFB - you're so knowledgeable and really reassuring and well informed - bless you for all this information

I used to be the most laid back person ever but pregnancy is turning me into the biggest worrier ever about everything!

Its so good to hear from others who are going through similar things and who are so lovely and reassuring too - so pleased to know Im not the only worrier

My DH is good up to a point but perhaps guys don't experience the same level of worry as they are not physically going through it this makes them very laid back and not worried about the whole pregnancy thing so I have had to be worrying on my own - or at least that's my experience with my laid back DH!

Thank you for the link which I will read - I was so under prepared at my scan and just didn't ask any of the right questions so its so good to be able to talk to others who are very well informed and knowledgeable - thank you so much CrispyFB - I feel so much more reassured :)

You're welcome! I waited it out for 20 weeks with a 1 in 34 risk last pregnancy as I didn't want to risk invasive testing, and you learn a lot in that time obsessing

I'm usually really laid back too - but pregnancy turns me into a basketcase of worry. Once they're out and past the SIDS stage though thankfully I turn into far less of a worrier. In fact I probably appal some other parents by the way I let mine climb on all sorts of "unsuitable" playground equipment and so on - that's just my natural laid back attitude. But pregnancy.. it does my head in for worry!!

Men definitely don't worry. As wonderful a father as my DH is, pregnancy disinterests him totally and unless there is something concrete to worry about (and even then he deliberately avoids thinking about it) he is no more concerned than he would be if I caught a cold. It's hard for them to empathise when they're not aware of the baby 24/7 like we are.

Glad you feel more reassured - I honestly think your results are great!

thanks CrispyFB - you sound so wise and thank you again for the reassurance

yes pregnancy indeed is turning me into a basket case and the poor DH is so clueless and a bit disengaged about the whole thing so I feel like Im talking to a brick wall sometimes even though I know he cares

yes I think the whole way through pg there are things to worry about - so much for the glowing enjoyment of it all - Im as sick as a parrot physically and worrying for england and as for the glow its more of a frazzled grey shattered look :(

I chose to get the Nuchal measurement only- purely as i'd read so many reports of the other 2 tests being a) inconclusive and b) overstating anomalies. I have no clue whatsoever whether i've made the right decision in doing this, as statistically doing all 3 will give more accuracy obviously, but given my NT was 0.49 i was happy to leave it at that and move on.

NT of 1.7 is well within the normal range so that's really good.

Did the clinic/hospital not tell you what your statistical chance was, based on your results?? they should have, i would have thought

Pregnancy glow is what women have photoshopped on in magazine photos

Once you get movement you worry about that, then you worry about the birth, then SIDS.. it's somewhat relentless! Nothing prepares you for the constant worry and anxiety, it hit me like a brick the first time!

I escape the worst of the vomiting and "just" have severe nausea, but SPD is my nemesis, leaving me with serious mobility issues from 20 weeks onwards. And I've been high risk for the last three pregnancies due to incompetent cervix issues (and the aforementioned abnormal blood test results) so I am definitely not one of those women who thrives in pregnancy!! I'm 31 weeks now so not much longer to go, and this is my last pregnancy, yay!!

Ahw much sympathy for you CrispyFB - so sorry to hear you have all that to worry about as well - here's keeping my fingers crossed for you that the last bit of pregnancy goes really well for you :)

wish I could have the photoshop experience to pep up and gloss up my sorry state - hooray for winter clothes to hide beneath!

thanks chica for your reply - that's such a good result you had for your NT - that's so good and must be really reassuring
I think sometimes the more tests one has the more worry it causes - certainly that is the case for me :)

I was given a risk factor of 1 in 450 which I think is in the low risk band but no one explained the HCG or PAPP-A results at the hospital to me so it just left me doing a panic search on google and finding all sorts of scare stories with high readings of both - grrr to mr google :(

But very kind Crispy has helped to reassure me that its mainly seen as a potential problem when the HCG is high and PAPP-A is low (hope Ive read that correctly - this is where I wish I was more scientifically orientated and had paid more attention at school!)

Ha yes - lots of concealer for the dark circles under my eyes and lots of big woolly jumpers!

1 in 450 is fabulous.. nothing to be worried about at all! You're right - it's the low PAPP-A and high bHCG that is a concern for Down Syndrome. I believe it's low PAPP-A and low bHCG that is a concern for the two other trisomies which are fatal. Neither applies to you!

Many thanks Crispy - that is reassuring

yes concealer and jumpers are my best friend at the moment :)

Mine has come up higher risk but the following numbers. Which but would the the reason for concern as I’m absolutly clueless. Also can you see a nose bone in the photo ?