Low Papp a **warning from MNHQ - this thread mentions baby loss**

[Ruthio1000]

At my routine 12wk scan bloods, it was picked up I had low Papp a. I started on medication straight away and was told not to worry. It’s really common etc etc.
I had previously had two boys and One was natural and my second was clomid. This baby was also a clomid baby.
I heard the heart beat at my 16 week scan and that was ok too.
I went for my 20 week routine scan. I was discussing names in the waiting room with my husband. Our two sons were desperate to see us when we got home as we’d promised them a picture of their baby brother or sister.
The bursary has just had new carpets fitted and walls painted.
We then got the devastating news. “There’s no heartbeat. I’m so sorry”.
My world crashed down. I went into shock and spent the next three hours in hospital filling out forms, getting blood taken and making plans for giving birth to my dead baby.
I went home for three days to wait for the pills to work and be booked in for an induction.
The shock was the worst as every forum I read was just good news story’s.
My midwife told me I’d be fine.
I wished I’d been more prepared. Telling my 5 year old there was no more baby was the worst.

On December 24th 2019 myself and my husband buried our gorgeous girl Poppy with my grandma.
We go and visit her often and I find it helps acknowledging we had a baby rather than pretending it didn’t happen.

10 months on and I’m 18 weeks pregnant today.
Im terrified but bloods haven’t showed low Papp a. Phew....
This was a natural pregnancy for the first time in 6 and half years of constant trying.
I’m hoping that’s a sign it’s meant to be this time.

This message isn’t meant to upset anyone.
I just wished I’d been more prepared of the risks.
The autopsy didn’t give us any answers, but the only link I can put our devastating time to is low Papp a.

Wishing all you other mums to be the best luck as I’d never want anyone to go through what we went through.

I’m praying for a healthy baby which is due end feb 2021.

I'm very sorry for your loss. However as a FTM, 14 weeks pregnant with our miracle baby and diagnosed with low PAPP-A this is not what I needed to read. I clicked on this thinking it was a fellow mum to be in the same position as me. Whilst I appreciate the intent behind sharing your story a heads up in the subject line or early on would have told me that I shouldn't read on. Unfortunately I am well aware of the risks of low PAPP-A, miscarriage is listed on every medical website and the pamphlet I received. Im dealing with anxiety and was only just starting to feel hopeful about my pregnancy. I hope this doesn't come across as rude and I am so sorry for the loss of your baby girl and wish you a healthy pregnancy.

Sorry reading that back it does sound rude, I think that's my pregnancy insecurity showing.
I appreciate you sharing your story, it must be hard to do that. I cant imagine what you went through and I hope that your current pregnancy goes well x

Sorry I agree with @LottieDot on this one. It's absolutely horrific and sharing your story is so so important. However, maybe a warning in the title? Just so mums to be with low Papp-a don't go read it and then are filled with anxiety. I've spent the whole of my pregnancy and absolute mess because of my low Papp-a and that's without seeing stuff like this. My heart absolutely breaks for you and I can't imagine what you've been through but I'd definitely stick a warning in the title if you can. Then people have the option to read. Best of luck with this pregnancy x

In the same position as @LottieDot ... I’m 16 weeks and have Low PAPP-A, clicked into this thread to share experiences with someone in the same position and the content is quite upsetting. Of course I am so sorry to you OP. But perhaps something in the title would be more appropriate? @LottieDot Hope you’re doing well, are you taking aspirin? I already have a DD and didn’t have low PAPP-A diagnosed last time but she did have a low birth weight (slightly low) so that all ties in.

@LottieDot @LittleRa if it helps you both I've had a shit time with all this since 12 weeks. I'm now 36 weeks and although small, he seems to be doing okay (but I'm 5ft and partner is short as well, so small baby to be expected). I've been on aspirin since 12 weeks. All the midwives and sonographers have said to me low Papp-a is just a precaution and nothing is definite. And if the outcomes were that horrific it would be a compulsory test. I am getting induced early though because he's just a little tiny dot on the 10th centile of his growth chart, but all my Doppler scans have shown no issues with placenta function etc.

So please try not to worry too much! Despite this post🙈xx

@LottieDot and all, thank you for your response to the OP. OP I am terribly sorry to hear what you have gone through, I can’t possibly imagine how you must have felt. However, having had the low PAPP-A news at 12 weeks (now 19 weeks), I had clicked on the post hoping for reassurance from other mums to be going through the same situation. Instead the post has left me feeling petrified for my 20 week scan next week.

@Danielle95lab, thank you for the positive comments, it’s really reassuring to hear! Do you mind me asking what your levels were? Mine were 0.27 which feels incredibly low

@Danielle95lab and @LittleRa thank you, its a difficult balance of being aware of all the possible outcomes but not spending your whole pregnancy in dread isn't it. Hope both your pregnancies are going well. I'm so sorry OP had the worst possible outcome.

@LittleRa yes 150 of asprin every day and will start growth scans at 28 weeks how about you? My mum had 2 small babies (not tiny but 5 and 6lbs), my brother was born 3 weeks early as he stopped growing, but I dont think they tested for this back then. Its been a constant worry despite my Drs being reassuring.

@Swest30 good luck for your scan next week please let us know how it goes x

@Danielle95lab thats reassuring! Im sure once he's here he'll make up for it and grow nice and big. If baby is small that's fine, as long as they're healthy!

@Swest30 yeah mine were very low 0.21 it's gave me nothing but anxiety all the way through.

I've been scanned about 10x privates and nhs and he's very healthy and such an active baby. It's just he's going to be a small baby. But like I said that's more genetic than anything. Especially as placenta function hasn't been an issue for us so far. Good luck ladies! Try and enjoy some of your pregnancy at least 😂xxx

@LottieDot Yes same, 150mg of aspirin. My DD birth weight was 5lbs 7oz so not teeny tiny, but she was just below the “low birth weight” category cut off (I think she was 2400g and the cut off 2800g) so stayed in hosp two nights while feeding established etc but didn’t need any feeding tubes or anything.

I had my 16 week midwife appt this week and heard the heartbeat. The midwife actually said that the threadhold for PAPP-A being low has changed or something like that, and as a result lots more people that wouldn’t have had this result have been having it.

I will be having the growth scans from 28 weeks too and checking blood pressure etc. I feel well looked after. Obviously I do understand it means there’s an increased risk and it is devastating to read what has happened to the OP but I’m really hopeful all will be well, and for the others on this thread too.

@danielle95lab @littlera @lottiedot @swest30 I have stumbled across this post because I've just had a call about low Papp-A levels and immediately turned to Mumsnet for some recent real-life updates.
The OP's story is incredibly sad and my heart goes out to her. I can't imagine how she felt. It must've been a traumatic and devastating time for her and her family.

I'm 13 weeks and had a call about the results of my 12 week bloods. Thankful it's just the low Papp-A that's showing up and nothing else, but obviously I'm a wee bit concerned. I've been told to take 150mg aspirin every evening until I'm 36 weeks. My levels are 2.8. Midwife said other NHS trusts use anything under 2 as the bar for interventions, so I'm currently higher than most. I'd love to know how you guys are getting on?

@serenfach1 first of all don’t panic! I had my baby boy at 37 weeks in October. Low Papp-a did affect me unfortunately but not until very last minute. His growth very slowly dropped at 35 weeks, I was rescanned again at 37 weeks and he had gained but not enough. So I was induced that day. He must have been ready anyway cause within 24 hours he was born and they expected it to take days haha. He was 4lb 9oz but perfectly healthy. We had to stay in hospital 2 nights just because he was so small to make sure he was feeding okay. Then we were home. He’s now gaining lovely. Still only 9lb at 9 weeks but has come such a long way and is perfect. So yes it could cause problems, but it would generally just mean a small baby and early delivery (but they always try get you to full term). The midwife who delivered my son said it was the tiniest placenta she had ever seen, so it’s safe to say there was an issue. But he’s here, happy and healthy.

My story is pretty rare, I know many who have had the same thing and it’s not affected them in any way. In fact one woman had a little chunky 9lb two weeks early with low Papp-a. So please don’t let it ruin your pregnancy. Your so carefully monitored with low Pappa and worst case scenario is probably what happened to me if there’s no other concerning factors and I can assure you it was all fine!x

Just in case anyone else stumbles on this thread, there is a fantastic facebook group full of support and positive stories from people with low PAPP-A.

It's called Low PAPP-A pregnancy support group. It's given me so much reassurance.

@danielle95lab thanks so much for the reassuring reply. I'm so pleased everything is well with you and your baby. I'm prone to being a bit anxious anyway so this hasn't helped. I had 3 mcs (all 1st trimester) before my 1st child arrived, so I've always had an undercurrent of nervousness around my pregnancies.

Thanks @profInkly for the recommendation. I'll check it out!

@serenfach1 I can totally sympathise it caused me so much anxiety my entire pregnancy. As you can see from my previous comments, I was paying for private scans left right and centre to make sure he was okay (especially in the early stages when I couldn’t feel him move). But my biggest regret is not relaxing and embracing every moment. I robbed myself of the experience. It’s a really really common diagnosis at the moment now the threshold has been lowered and they never even use to test for it until recently. So if this had happened a few years back you’d be none the wiser. Good luck with your pregnancy, I’m absolutely certain you’ll have no issues xx

Low pap a doesn’t usually become an issue (if at all) until later in pregnancy - which is why additional scans don’t start until 28 weeks. I’m so sorry for your experience OP, what happened to you is truly awful, but there is no evidence to suggest what happened is a result of your low pap a. Suggesting that it was, and the title of your thread, could be very worrying to pregnant women going through the same.

Those that have been told they have low pap a, I have been there too. I was anxious and researched the risks. It all sounds very scary but some trusts don’t even offer routine additional scans as the risk is so small.

My low pap a baby was born 16 weeks ago with no issues whatsoever. He was a healthy 8lbs. Please try not to worry x