Papp -a question?

[Sleeplessem]

Does anyone’s hospital not test for it?

My last baby was a low birth weight and I’ve since learned that is an indicator of potential iugr and low birth weight.

I’m pregnant again and I’ve had my screening test results (all low risk) and asked about Papp a and was told the hospital doesn’t look at it? Does this sound right?

If you've had the combined screening test (the 12 week scan and blood test) then PAPP-a is one of the measures they use to get your result. Your screening result letter should show a breakdown of the three measures. So you should be able to see your PAPP-a figure there.

The hospital might mean that they don't do anything to treat low PAPP-a. It's still a new, and quite theoretical, test, and hospitals have different policies on dealing with it. If it's under 0.4 MOM then my local hospital gives low dose aspirin and extra scans, other hospitals have different approaches.

@SecondGentlemann I’ve had my screening results and it just saw for Down’s syndrome risk is 1 in 2555
Edwards and pataus risk is less than 1 in 10,000
This indicates that I am low risk and no further testing is indicated at this point.

It doesn’t mention anything about Papp a at all

@SecondGentleman sorry hit post before I’d finished. Basically the letter doesn’t give any breakdown of the three measures just the results xx

Papp-a is definitely involved in the screening process so should be recorded somewhere ....I had the same results letter both times (just the risk stats) but this time because we have digital notes my Papp-a has been added to that on the blood test section, I noticed because it seemed quite high! Bit of reading tells me that's ok but as I had an SGA/possible IUGR baby last time it was interesting to see.
So even if you haven't got access to it yet, somebody has a Papp-a value written down for you OP as that would have been used to calculate your risks. You midwife might be able to access where it's recorded?

@8dpwoah I have asked and they just said they don’t do anything with the results so there is no point. I’ve got the app too, badger, which is utter pants, nothing gets uploaded to it xx

If you call the fetal Medicine department on your letter (there will be a number somewhere on your results letter), ask them to email you a copy or just tell you what your results were and they will, I got mine emailed x

I got my 12 week scan results today on the Badger app and my Papp-A score is there too.

They don’t tend to put it in the letter but if you call, someone should be able to tell it to you. They use the number as part of the calculation so they will have tested for it, I don’t think they can give you your risks without it... I suppose they may not have recorded it but that seems odd.

I just realised I’ve left personal info on this

There's a couple of email addresses at the bottom of the letter - perhaps one of those would be able to help you?

Maybe they only record it in the letter if there's an issue?

I can understand your worries, I had the same problem and I would be concerned n the future.

Hope it all works out for you,

I’ll add my letter again

@jessicakxx there isn’t a contact number or anything
@TakeYourFinalPosition my badger app is completely empty not even my blood type has been added. I called and asked antenatal for the Papp a result and they said they can’t give it to me because they don’t use it…

My Papp-a and hcg results were not shown in letter. I had to call and get it x

My Papp-a turned up on the app weeks later under the blood and microbiology section 🤷‍♀️

I think we could do a whole new thread on the crapness of the app (or the lack of stuff being put into it...)!

Ah okay, you just need to call the antenatal department at your hosp, will be on your 12 week scan letter. Then when you get through just ask to be put through to fetal Medicine. You might find number on google too. Thinking back actually my midwife gave me the number.

Although your results look really really good so I'd imagine your Papp-a and hcg were normal x

@jessicakxx I called the lab and they told me they can’t give info to me as I’m not a medical professional 🤷‍♀️ Midwife is clueless about it too… sigh… off to a great start care wise. Worse because my dd was low birth weight.

@8dpwoah ain’t that the truth. So far my app has my name and notes from telephone booking appointment. And all other blood and test results are down as ‘not published’

@jessicakxx I called ante natal too and they said they don’t use it so don’t have it, they were the ones that told me to call the lab lol

Can you ask what is is at your next midwife appointment? It might be on their digital records? It should also be on your bloods results that are filed in your blue folder? It might just take a while to come through. If it's not been flagged then it must be in the normal range. Mine was low and I got a phone call from a consultant at 16 weeks and was consultant led from that point on, but was all fine and my baby was an above average weight. They should be able to tell you it regardless.

That's absolutely ridiculous because it's your personal information. Best thing to do is call your midwife, explain you've tried several routes to obtain and no one is helping and request she obtains them for you. X

Should mention though as well that if you have your letter with your screening risk, you would have received a letter on the same day or earlier with telling you your Papp-a is low/ you would have also got a call from the hospital telling you; before they send out your letter/ so I think you're fine :)

@laravix I asked and apparently they don’t have access to it because it’s not something they act on at all.

@jessicakxx I’ve called her and she said she can’t see it, it’s not on any of the notes, she doesn’t even know my screening results yet, I have to bring the letter to show her so she can record it. To me this seems crazy backwards. I’m not sure they’d tell me if it was low as apparently the hospital don’t pay any regard to Papp-a?

That's really odd, make sure you're persistent as you should have access to it. The hospital will take PAPP-A into account; it's used as a metric in the combined screening as well as being a soft marker for other things. If you haven't heard anything by 16 weeks you must be in the normal range as they would have asked you to begin to take low dose aspirin by now if you had a low result. Understand your worry and frustration though so I would still ask for it for peace of mind. Good luck

@laravix that’s what I thought too but I directly asked do they put women with low Papp a on aspirin and they said no, they just offer growth scans if fundal height is too small… seems insane to me and I’m not sure if it’s a general cba attitude

@Sleeplessem my hospital/midwife team don't do aspirin for papp-a. I have just been transferred to consultant led care for monthly scans. Depends from trust to trust

I hate the Badger app so much. I had to switch to it halfway through my last pregnancy from paper notes and although I generally like technology, I preferred paper notes by miles. I really think the app deprives women of visibility and control over their personal information, and I can’t help but wonder if that’s deliberate.

Anyway - rant over - I think you can assume on the basis of your overall results (which are really good) that your Papp-A was fine. You would have been told if it wasn’t. But I totally get why you want to know the actual value!