Hello, I had a Papp A of 0.26 in my second pregnancy. I was also anxious as a result. I had had an uncomplicated first pregnancy.
Firstly, for me, this made me higher risk for Downs and I decided to get the NIPT to give me more knowledge and reassurance about that. Whether you’d want to know about that and how you’d deal with it is if course very personal. I also had to pay for NIPT at that time. You don’t say but it may well be you are not considered higher risk for Downs anyway - I was in my late 30s which may have also been relevant to the calculation. I was told I was low risk for Downs following that but that the Papp A in itself also would mean some additional monitoring.
It’s quite difficult to stop yourself Googling it, but the whole area of knowledge around Papp A seems to be fairly new and exploratory and there’s quite a lot of contradictory stuff online (mostly, I found, other parents having done their own research online!).
The most useful materials I found basically explained it is a risk factor for potential SGA and pre-eclampsia. There is also some research which shows there is potentially some correlation with a higher risk of a few other complications but there isn’t any research (I believe) which actually explains a connection between any of these things. However, a very helpful consultant explained to me that the risk of any of those things arising is still low. It’s just a risk factor, in the same way as other things (age, previous complications in a pregnancy) might be for other people. The fact is, some years ago, you would not have even known your Papp A results and the likelihood is that the pregnancy would have progressed absolutely fine.
It seems that different NHS Trusts treat the issue in different ways because the research is still developing. I was at a specialist London teaching hospital and there they were trialling giving women with low Papp A results a daily aspirin dose of 150mg (higher than other Trusts and some Trusts are not suggesting anything). You may want to enquire about that if you are anxious and ask to see an obstetrician rather than a midwife if you wish to discuss the details (that’s what I did).
The same consultant explained that the aspirin is not given for thinning blood and so making it easier to get to the placenta (which is what some people seem to understand online). She explained that it is for ensuring the blood vessels in the placenta continue to operate properly.
As well as the aspirin, I was also told I may need extra scans. We had one extra scan, but did not need additional ones beyond that because the baby had been growing well.
Good news! My pregnancy progressed well and I had a healthy little boy in November 2018 at 38 weeks exactly (which is considered full term) weighing 6lb14oz, a little on the small side but no concerns about that.
Interestingly, although again this would be a decision you have to make based on the circumstances at the time, the hospital had suggested that I may not want to go beyond 40 weeks (because that in itself is another risk factor for some of the same things). In the end, I didn’t need to think about that because I went into labour naturally. Honestly, I had been quite worried about being induced if I had gone beyond 40 weeks but I actually needed to in the end because I caught an infection in early labour (nothing to do with the Papp A at all, to do with my waters). I had been slightly concerned about being induced only because my first birth was in a birthing pool using Hypnobirthing techniques and I really enjoyed it and being induced felt a long way from that! In fact, being induced - and then having an epidural - was actually amazing for me and I had wondered what I’d been so worried about!
Most importantly-and it’s easy for me to say now-try not to be anxious because I do genuinely think that has an impact on your mental well-being during the pregnancy and probably on outcomes to. If you can, I would recommend trying to do some relaxation exercises and try not to Google too much!
Sorry for the long message - I had been meaning to write something online to reassure other mums as I know I would have appreciated it when I was pregnant.
Good luck!