Low Papp A and Gestational Diabetes

Mammabee20 · 2019-11-06T22:16:42+00:00

Hi all [smile] I am hoping you lovely mumsnetters will help calm down my worrying! I have low Papp A, it was <0.40 MOM (apparently it was only slightly lower than they like) I had my DS and EP’s tests and they both came back fine. Because my BMI was slightly higher and I had an EMCS with my DD they have marked me as high risk and I need to have the extra scans and things. Well I spoke to a consultant and they said they cannot see any reason why I cannot try and have a VBAC and the chances of it being successful are good as I got to 10cm dilated Previously.. I went to a labour matters meeting and the senior midwife said the same thing practically and she said i was just too exhausted by the sounds of it and it may have been because my body wasn’t Physically strong enough due to having undiagnosed gallstones (I’ve had surgery now and the gallbladder has been removed entirely) and being on gas and air for as long as I was. So I started to get super excited about maybe trying for another birth again but also thinking should I just let them get my DS out via a c section so I know he will be okay or because there are risks associated with both MOD do i just try.. I just don’t want anything to happen to him at all. Anyway I have had my glucose tolerance test today (not had the results yet) and now I have read up from the electronic labour leaflets on the labour notes app what can happen when you do have that and I am already aware of every possibility of something going wrong with low Papp A that I am starting to really worry that I have fallen in love with this unborn baby boy (who we have named [sad]) and I am going to end up having a stillbirth [sad] Can anyone please advise what labour method they would choose or whether anyone has been in a similar situation.

6 replies

Mammabee20 · 06/11/2019 22:16

Hi all I am hoping you lovely mumsnetters will help calm down my worrying! I have low Papp A, it was

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Original poster

Mammabee20 · 06/11/2019 22:17

I am so sorry if I started to ramble

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Nanmumandmidwife · 07/11/2019 09:14

You sound so worried and I feel sad that although you have seen lots of people no-one seems to have talked things through very well with you.
Please don't worry about the PAPP-A result. There is little evidence to suggest that this indicates any issue at all & there is no consistency about the level at which maternity units take interest - some set a much lower result as being of interest & so would not have even commented on it! As you are having extra scans your baby's growth is being monitored closely.
It is good that you have had the gestational diabetes screening test. If it is developing you can be monitored and helped to keep the blood sugar level in the normal range which is what is important for your baby. If the test result is normal, then it is one less thing to worry about.
I think most of us have worried about the risk of stillbirth, but by being aware of eating well, being aware of baby's movements and reporting any concerns quickly, you are doing your very best.
From what you have said it sounds entirely reasonable to aim for a vaginal birth. Babies are designed to be born that way. Labour helps to prepare them for the ending of "womb service" so that they are more ready for taking responsibility for breathing etc than a baby who is lifted out at a planned c/section.
When do you have your next appointment with your midwife or consultant? Please make a list of your concerns and ask them to go through them with you. As midwives we have loads of knowledge and most will be very happy to spend time sharing that knowledge with you so that you can feel more confident & look forward to meeting your baby boy.

Original poster

Mammabee20 · 07/11/2019 15:30

Thank you so much for your advice! I really do worry as I just want everything to go right this time and not feel like a failure with this labour 😭 I do feel like I could try but what happens if he starts to struggle & he is born stillborn.. I don’t want that to happen so I don’t know whether to just take a c section option or do things not occur that quickly.

I have rung the hospital for my GD results and they have said it has come back normal so I am feeling a bit more relaxed today

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Nanmumandmidwife · 07/11/2019 18:24

I'm glad to hear that your GD result was normal. One less thing to worry about!
Because you have had a c/section it will be advised that you are even more closely monitored this time. Very very rarely do things happen suddenly. Careful monitoring will usually identify if there are problems brewing with plenty of time for us to act. Sudden and unexpected death during labour is extremely rare for this reason in the UK.
What was the reason that a c/section was decided on last time as you had got to 10cm? You didn't "fail" if you needed a section. You needed the help of 21st century medicine to give you and your daughter the best possible future. It may well be different this time. Make sure you keep eating little bits and drinking as you can through labour to keep your energy levels up.
Have you considered doing a hypnobirthing class? It would give you lots of useful life skills whatever happens in labour, and most give you very helpful advice and information about birth generally.

Original poster

Mammabee20 · 07/11/2019 18:50

Thank you! I feel so much better and I am starting to feel more and more confident about a VBAC but only if I can have a EMCS quickly if things start to go wrong. The reason for the c section last time was just that I was absolutely exhausted I had been in stage 2 for a long time and they tried forceps three times and my daughter still wasn’t moving.. the senior midwife said I must have been pushing and giving it my all because the surgeon tried 3 times before giving up and deciding to do a c section. I don’t remember eating or drinking after lunch on Thursday and she was born at 5:52 on the Friday 18th October and I had been on gas and air continuously since after lunch on the Thursday

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Nanmumandmidwife · 08/11/2019 17:52

No wonder you were tired! You can be sure that they will be watching you carefully this time and will not leave you having contractions for hours if there is not good progress towards birth.
Go for it- a c/section can be arranged and done in minutes if we have to, but it can be calmly decided on if progress slows down.
Good luck! Let us know how it goes x

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